【摘要】 目的 观察根除幽门螺杆菌对糖尿病胃轻瘫（DGP）的治疗作用。 方法 选择2008年3月-2010年1月100例幽门螺杆菌阳性DGP患者。随机分为A、B两组。A组给予莫沙比利5 mg，3次/d，4周，及根除幽门螺杆菌治疗（埃索美拉唑 20 mg+克拉霉素 500 mg+阿莫西林1.0 g，12次/d）2周。B组采用莫沙比利5 mg，3次/d，4周。记录患者治疗前、治疗4周及停药4周时的症状积分。 结果 92例完成实验。A组症状积分治疗4周后明显下降（Plt;0.01），与停药4周后相比差异无统计学意义（Pgt;0.05），二者均明显低于B组同期（Plt;0.05、lt;0.01）。B组症状积分治疗4周后明显下降（Plt;0.01），停药4周后明显高于治疗4周后（Plt;0.05），但仍低于治疗前（Plt;0.05）。A组治疗4周及停药4周后显效率及总有效率分别为57.4%及91.5%、40.4%及83%，明显高于B组35.6%及75.6%、15.6%及53.3%（Plt;0.05）。 结论 对幽门螺杆菌阳性的DGP患者根除幽门螺杆菌可明显提高疗效，并有效防止停药后症状复发。【Abstract】 Objective To explore the therapeutic effect of helicobacter pylori (H.pylori) eradication on diabetic gastroparesis (DGP) patients. Methods A total of 100 DGP patients with H.pylori infection diagnosed between March 2008 and January 2010 were included and randomly divided into two groups. The patients in group A underwent the treatment with mosapride 5 mg (thrice per day) for four weeks and H.pylori eradication therapy (esomeprazole 20 mg, twice per day; clarithromycin 500 mg, twice per day; amoxicillin 1.0 g, twice per day for two weeks). The patients in group B was administered with mosapride 5 mg (thrice per day) for four weeks. The symptom scores (SS) were recorded pretreatment, 4 weeks later and 4 weeks after stopping treatment. Results Ninety-two patients finished the study. The SS in group A decreased significantly (Plt;0.01) 4 weeks after the treatment and didn’t differ much from that 4 weeks after stopping the treatment. Both of the SS were lower than those in group B at the same time. In group B, compared with that before the treatment, the SS were much lower than that 4 weeks after the treatment (Plt;0.01) and 4 weeks after stopping the treatment (Plt;0.05); the former was significantly lower than the latter (Plt;0.05). The marked efficacy rate and total efficacy rate in group A were higher than those in group B (4-week treatment: 57.4% and 91.5% vs. 35.6% and 75.6%, 4 weeks after stopping the treatment: 40.4% and 83% vs. 15.6% and 53.3%) (Plt;0.05). Conclusion H.pylori eradication can increase the therapeutic effect on H.pylori positive patients with DGP and reduce the recurrence of the symptoms remarkably.
Gastroparesis is a gastrointestinal motility disorder that refers to delayed gastric emptying in the absence of mechanical obstruction. Clinical manifestations include postprandial fullness and epigastric discomfort, abdominal distension, nausea, and vomiting. According to its etiology, it can be divided into three categories: surgery-related gastroparesis, non-surgery-related gastroparesis and idiopathic gastroparesis. Non-surgery-related gastroparesis is common clinically. At present, the exact pathogenesis of gastroparesis remains to be unclear. The intestinal flora is huge and abundant. It participates in a variety of physiological functions of the host. Studies have confirmed that the intestinal flora is related to perioperative treatment measures, surgical stress, and various system diseases (endocrine and metabolic system diseases, nervous system diseases, and immune system diseases), especially the weakening of gastrointestinal motility, and gastrointestinal motility. Attenuation can further promote the occurrence and development of gastroparesis. Based on the current research, this article reviews the research on the correlation between gastroparesis and intestinal flora.