| Objective1. To observe the influence of proton pump inhibitor(PPI) on clinical symptoms in patients with functional dyspepsia(FD).2. To investigate the indication of PPI in the treatment of FD.3. To investigate the influence of PPI on the gastric electrophysiology in patients with FD.Methods1. The bioimpedance gastric motility based on a wavelet transformation technical was used to detect the electrogastrogram(EGG) and impedance gastric motility(IGM) in normal gastric emptying healthy volunteers(n=30),which was cofirmed by a semisolid nuclide technology, and FD patients(n=132).2. The symptom integral method was used to investigate the influence of lansoprazole(30 mg qd) and rabeprazole(20mg qd) on FD patients.3. The bioimpedance gastric motility detector was used to explore the influence of PPI on the EGG and IGM in FD patients.Results1. After treatment with lansoprazole, the 2 weeks’ effective rate of patients in EPS(n=23),PDS(n=17) and EPS+PDS(n=26)were 21.74%, 17.65%,26.92%. The 4, 6, 8 weeks’ of that were(52.17%,52.94%, 53.85%),(56.52%,52.94%,57.69%) and(60.87%,58.82%,57.69%), respectively. The effective rate had no statistical difference among the three subtypes in the same treatment period.(P>0.05).After treatment with rebaprazole, the 2 weeks’ effective rate of patients in EPS(n=18), PDS(n=23)and EPS+PDS(n=25) were 27.78%,17.39%,28.00%. The 4,6,8 weeks’ of that were(60.00%,47.83%,56.00%),(60.00%,47.83%,60.00%) and(60.00%,56.52%,60.00%), respectively. The effective rate had no statistical difference among the three subtypes in the same course of treatment(P>0.05).2. The effective rate of the both groups after 4 weeks’ treatment were significantly higher than those in the 2 weeks’(P<0.05),but had no statistical difference than those in 6 and 8 weeks’(P>0.05).After 2,4,6,8 weeks’ treatment with rebaprazole, the effective rate were 24.24%,56.06%,57.58%,and 60.61%, which was higher than those in lansoprazole group(22.73%,53.03%,56.06%,59.09%), respectively, but with no statistical difference(P>0.05).3. According to the 95% CI of the IGM of low frequency percentage [(31.84~34.54)%], intermediate frequency[(52.09~54.13)%], high frequency[(13.07%~14.32%)] in the healthy volunteers, the patient with abnormal IGM in epigastric pain syndrome(EPS),postprandial distress syndrome(PDS) and overlapping group(EPS+PDS) were 68.29%,70.00% and 66.67%,respectively, and it had no statistical difference(P>0.05).4. After two weeks treatment with lansoprazole,the percentages of the low frequency of EGG significantly reduced [(32.13±3.15)% vs(35.27±4.60)%], the intermediate frequency[(53.12±2.19)%vs(51.36± 3.09)%] and the high frequency[(14.44±1.71)% vs(13.28±3.96)% ] was markedly increased(P<0.05).In the 4 weeks treatment course, the percentages of the low frequency[(29.04±1.93)%] of EGG was further reduced, the intermediate frequency [(55.18±1.68)%] and the high frequency [(15.87±1.27)%] was much more increased(P<0.05).The percentages of the low frequency of EGG in rebaprazole group was significantly decreased [(32.75±3.21)% vs(34.96±3.77)%] after two weeks’ treatment, the intermediate frequency[(53.03±1.46)%vs(51.48±3.12)% ] and the high frequency[(14.74±1.82)% vs(13.56±2.44)% ] was markedly increased(P<0.05).After treatment with rebaprazole for 4w,the percentages of the low frequency of EGG [(29.48±1.98)%] was significantly reduced, the intermediate frequency[(55.11±2.13)%] and the high frequency [(16.03±1.28)%] were markedly increased than those of 2w course of treatment(P<0.05).5. After treatment with lansoprazole for 2 weeks, the percentages of the low frequency[(35.41±2.41)%vs(36.65±2.03)%],intermediate frequency [(51.35±2.08)% vs(50.33±1.99)%] and the high frequency[(13.35±1.98)% vs(13.08±2.24)%] of IGM, had no statistical difference(P>0.05). After treatment with lansoprazole for 4 weeks the low frequency of IGM [(31.53±1.88)%] was significantly decreased, the intermediate frequency [(53.48±1.49)%] and the high frequency[(14.66±1.14)%] was markedly increased than those of 2 weeks treatment course(P<0.05). After treatment with rabeprazole for 2w, the percentages of the low frequency [(34.97±2.01)%vs(35.99±2.41)%],intermediate requency[(51.55± 2.08)%vs(50.63±2.18)%] and the high frequency[(13.31±1.56)% vs(12.99±2.47)%] of IGM in FD had no statistical change(P>0.05). After treatment with lansoprazole for 4w, the low frequency of IGM [(32.05±1.68)%] was significantly decreased(P<0.05), the intermediate frequency[(53.77±1.50)%] and the high frequency[(14.55±1.04)%] was markedly increased(P<0.05).6. According to the 95%CI of IGM of the normal gastric emptying healthy volunteers, the FD patients was divided to the normal IGM and abnormal subgroup. After two weeks’ treatment with lansoprazole, the effective rate had no significant difference between the normal(n=22)(18.19%)and abnormal IGM subgroup(n=46)(25.00%)(P>0.05), but the effective rate of abnormal IGM subgroup in 4, 6, 8 week(63.64%,65.91%, 68.18%)was much higher than that of the normal IGM group(31.82%, 36.36%,40.91%)(P<0.05), respectively.After two weeks’ treatment with rebaprazole, the effective rate had no significant difference between the normal(n=20)(20.00%)and abnormal IGM subgroup(n=46)(26.09%)(P>0.05), but the effective rate of abnormal IGM subgroup in 4, 6, 8 weeks(67.39%,67.39%,69.57%)was much higher than that of the normal IGM subgroup(30.00%,35.00%,40.00%), respectively.The effective rate of rebaprazole and lansoprazole group patients with same IGM condition had no statistical difference in the same treatment course(P>0.05).Conclusion1. Both the lansoprazole and rabeprazole can apparently improve the symptoms of patients with FD, regimen of 4w is better than 2w, and it has no beneficial to further lengthen the treatment course.2. There has no difference in the effective of lansoprazole or rabeprazole on the subgroups of FD, and FD classification of Rome III criteria has little value in therapy choice.3. Ameliorating the EGG and IGM parameters is one of the mechanisms that lansoprazole and rabeprazole in the treatment of FD. |
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