NOVEL EVALUATION AND TREATMENT OF GASTRIC DYSMOTILITY

胃动力障碍的新颖评估和治疗

• 批准号: 6516798
• 负责人: HENRY PAUL PARKMAN
• 金额: $ 10.77万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6516798
• 关键词: botulinum toxins; breath tests; chorionic gonadotropin; clinical research; diagnosis design /evaluation; electromyography; emesis; erythromycin; estrogens; gastrointestinal disorder chemotherapy; gastrointestinal disorder diagnosis; glucose tolerance; human subject; human therapy evaluation; menstrual cycle; morphine; nausea; noninsulin dependent diabetes mellitus; paralysis; pregnancy; progesterone; stomach; stomach disorder; stomach motility /pressure

Gastric dysmotility may be due to delayed gastric emptying, antral hypomotility, and/or gastric dysrhythmias. Gastric motor dysfunction is an important component of several clinical disorders including gastroparesis, functional dyspepsia, and intestinal pseudoobstruction. Our overall hypothesis is that gastric motility can be measured conveniently with noninvasive tests which can have widespread availability and provide clinically relevant information. The studies described in this research protocol will address our long-term research objectives of evaluating and treating disorders of gastric motility using simpler, less expensive, and less invasive techniques. Each of these patient-oriented research protocols involves the close interaction between the principal investigator and beginning clinical investigators in order to encourage and develop their clinical research potential. The first specific aim is to demonstrate the clinical validity of two novel noninvasive techniques to assess gastric motility. We will develop the 13C-octanoate breath test for gastric emptying into a practical, clinically useful test for the measurement of gastric emptying using an easily prepared standardized meal. We will also assess the clinical utility of a newly modified electrogastrographic instrument that records high frequency gastric myoelectric activity (up to 120 cycles per minute), in addition to the usual 3 cpm activity. The second specific aim is to use these two noninvasive tests (breath testing and electrogastrography) to assess gender-related aspects of gastric motility. We will demonstrate the effects of gender and the menstrual cycle on gastric motility and determine if the changes in gastric motility during the menstrual cycle correlate with estrogen . and progesterone levels. We will determine whether gastric motility is altered during pregnancy, and to investigate if nausea and vomiting that occurs in the first trimester of pregnancy are related to gastric dysmotility and/or alterations of estrogen, progesterone, and/or chorionic gonadotropin blood levels. The third specific aim is to explore novel treatment strategies for abnormal gastric emptying. We will determine whether accelerating or delaying gastric emptying affects postprandial glucose tolerance in diabetic patients. We will determine whether botulinum toxin injection into the pyloric sphincter improves gastric emptying and symptoms in gastroparesis. The fourth specific aim is to enable the principal investigator to continue and even expand his mentoring activities for beginning clinical investigators in patient- oriented research to include mentoring of specialized motility fellows, gastroenterology fellows, medical residents, medical students, and college students.

胃不动障碍可能是由于胃排空，肛门低电动性和/或胃不症缺失症引起的。胃运动功能障碍是几种临床疾病的重要组成部分，包括胃轻瘫，功能性消化不良和肠道假虫结构。我们的总体假设是，可以通过非侵入性测试来方便地测量胃运动，这些测试可以具有广泛的可用性并提供临床相关的信息。本研究方案中描述的研究将探讨我们使用更简单，更便宜和侵入性较低的技术评估和治疗胃运动疾病的长期研究目标。这些以患者为导向的研究方案中的每一个都涉及主要研究者和开始临床研究人员之间的密切相互作用，以鼓励和发展其临床研究潜力。第一个具体目的是证明两种新型非侵入性技术评估胃运动的临床有效性。我们将开发13C-八十度的呼气测试，以使用易于制备的标准化餐，以实用，临床上有用的测试，以测量胃排空。我们还将评估新修饰的电as人术仪器的临床效用，该仪器还记录了高频胃肌电活动（每分钟高达120个周期），此外还有通常的3 CPM活性。第二个具体目的是使用这两种非侵入性测试（呼吸测试和电兼术）来评估与性别相关的胃运动方面。我们将证明性别和月经周期对胃运动的影响，并确定月经周期期间胃运动的变化是否与雌激素相关。和孕激素水平。我们将确定怀孕期间的胃运动是否改变，并研究怀孕头三个月发生的恶心和呕吐是否与胃不良障碍和/或改变雌激素，孕酮和/或绒毛膜性促性腺激素血液水平有关。第三个具体目的是探索异常胃排空的新型治疗策略。我们将确定加速或延迟胃排空是否会影响糖尿病患者的餐后葡萄糖耐量。我们将确定注射到幽门括约肌中的肉毒杆菌毒素是否可以改善胃清洗中的胃排空和症状。第四个具体目的是使主要研究人员能够继续甚至扩大他的指导活动，以开始以患者为导向研究的临床研究人员，以包括指导专业运动研究员，胃肠病学研究员，医学居民，医学生和大学生。