Therapeutic efficacy of acotiamide in patients with functional dyspepsia based on enhanced postprandial gastric accommodation and emptying: randomized controlled study evaluation by real-time ultrasonography
Therapeutic efficacy of acotiamide in patients with functional dyspepsia based on enhanced postprandial gastric accommodation and emptying: randomized controlled study evaluation by real-time ultrasonography
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DOI：
10.1111/j.1365-2982.2012.01897.x
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发表时间：
2012-06-01
影响因子：
3.5
通讯作者：
Tack, J.
中科院分区：
文献类型：
--
作者：
Kusunoki, H.;Haruma, K.;Tack, J.
背景：有报道功能性消化不良（FD）患者服用阿考替胺后主观症状得到改善。证实改善与膳食有关的症状，如餐后饱胀，上腹部腹胀，早饱。我们研究了阿考替胺对FD患者胃调节反射（GAR）和胃十二指肠运动的作用机制。方法对34例FD患者（平均年龄40.4岁）在服用阿考替胺（100 mg，t.i.d.）或安慰剂给药。为了评估GAR，在仰卧位使用吸管每摄入100 mL液体餐（清汤，13.1 kcal; 400 mL）后测量近端胃横截面积的扩张率。接着，我们测量胃排空率（格尔）、运动指数（MI，胃窦收缩）和反流指数（RI，胃反流）以评估胃十二指肠运动。患者还在给药前后完成了一项基于7分Likert量表的调查。关键结果37例患者中，19例服用阿考替胺，18例服用安慰剂A，400 mL摄入后，阿考替胺组和安慰剂组的GAR差异有统计学意义（21.7%vs 4.4%）。阿考硫胺组治疗后格尔率明显升高（P = 0.012），MI、RI两组间无显著性差异。阿考替胺组和安慰剂组的改善率分别为35.3%和11.8%。结论与推论阿考硫胺可显著提高FD患者的GAR和格尔率。阿考硫胺可能对FD患者具有治疗潜力。
Background Improvement in subjective symptoms has been reported in functional dyspepsia (FD) patients administered with acotiamide. Improvement was confirmed in meal-related symptoms, such as postprandial fullness, upper abdominal bloating, and early satiety. We examined the mechanism underlying the effects of acotiamide on gastric accommodation reflex (GAR) and gastroduodenal motility in FD patients. Methods Thirty-four FD patients (mean age, 40.4 years) were examined ultrasonographically before and after 14-18 days of acotiamide (100 mg t.i.d.) or placebo administration. To assess GAR, expansion rate in cross-sectional area of the proximal stomach was measured after every 100-mL ingestion, using a straw, of up to 400 mL of a liquid meal (consomme soup, 13.1 kcal; 400 mL) in a supine position. Next, we measured gastric emptying rate (GER), motility index (MI, antral contractions), and reflux index (RI, duodenogastric reflux) to assess gastroduodenal motility. Patients also completed a survey based on the seven-point Likert scale both before and after drug administration. Key Results Of the 37 cases, 19 and 18 were administered with acotiamide and placebo A respectively, significant difference was observed in GAR between the acotiamide and placebo groups (21.7%vs 4.4%) after 400 mL ingestion. GER significantly accelerated after treatment in the acotiamide group (P = 0.012), no significant differences were observed in MI and RI between the two groups. Improvement rates were 35.3 and 11.8% for the acotiamide and placebo groups. Conclusions & Inferences Acotiamide significantly enhances GAR and GER in FD patients. Acotiamide may have therapeutic potential for FD patients.