NOVEL EVALUATION AND TREATMENT OF GASTRIC DYSMOTILITY

胃动力障碍的新颖评估和治疗

• 批准号: 6703057
• 负责人: HENRY PAUL PARKMAN
• 金额: $ 11.27万
• 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/6703057
• 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.

胃动力障碍可能是由于胃排空延迟、胃窦动力不足和/或胃节律失常所致。胃运动功能障碍是多种临床疾病的重要组成部分，包括胃轻瘫、功能性消化不良和假性肠梗阻。我们的总体假设是，胃动力可以通过无创测试方便地测量，这种测试可以广泛使用并提供临床相关信息。本研究方案中描述的研究将解决我们的长期研究目标，即使用更简单、更便宜和侵入性较小的技术评估和治疗胃动力障碍。每一个以患者为导向的研究方案都涉及主要研究者和初级临床研究者之间的密切互动，以鼓励和开发他们的临床研究潜力。第一个具体目标是证明两种新型无创技术评估胃动力的临床有效性。我们将把用于胃排空的 13C-辛酸呼气测试开发成一种实用的、临床上有用的测试，用于使用易于准备的标准化膳食来测量胃排空。我们还将评估新改良的胃电图仪器的临床实用性，该仪器除了通常的 3 cpm 活动之外，还记录高频胃肌电活动（高达每分钟 120 个周期）。第二个具体目标是使用这两种无创测试（呼吸测试和胃电图）来评估胃动力与性别相关的方面。我们将证明性别和月经周期对胃动力的影响，并确定月经周期期间胃动力的变化是否与雌激素相关。和黄体酮水平。我们将确定妊娠期间胃动力是否改变，并调查妊娠前三个月发生的恶心和呕吐是否与胃动力障碍和/或雌激素、孕激素和/或绒毛膜促性腺激素血液水平的改变有关。第三个具体目标是探索胃排空异常的新治疗策略。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糖耐量。我们将确定幽门括约肌注射肉毒杆菌毒素是否可以改善胃排空和胃轻瘫症状。第四个具体目标是使主要研究者能够继续甚至扩大对以患者为导向的研究中的初级临床研究者的指导活动，包括对专业运动研究员、胃肠病学研究员、住院医师、医学生和大学生的指导。