Therapeutic Effect Of Domperidone Combined With Epalrestat On Diabetic Gastroparesis

BackgroundDiabetes mellitus is a common chronic disease of serious human diseases.The latest research shows that the number of diabetes mellitus in the world now has reached 425 million.In recent years,with the aging of population and lifestyle changes in our country,diabetes prevalence rate has also increased rapidly.The number of diabetes has reached 121 million,because of the limitation of medical and health conditions and the lack of people's understanding of the disease.The characteristics of diabetic patients in China are low blood glucose control rate and high incidence of diabetes related complications.Diabetic gastroparesis is one of the manifestations of diabetic autonomic neuropathy.There has also been a marked increase in the number of cases.Studies have shown that diabetic gastroparesis not only leads to nutritional imbalance and weight loss in diabetic patients,but also affects drug absorption and makes it difficult to control blood glucose.In severe cases,it even leads to hypoglycemia and ketoacidosis.Therefore,active and effective treatment of diabetic gastroparesis is of great clinical significance.At present,the main treatment of diabetic gastroparesis is to actively and effectively control blood sugar on the basis of the application of gastric motility drugs.Some symptoms can be improved,but the condition is difficult to effectively alleviate,so this study design and application of domperidone combined with epalrestat is to treat diabetic gastroparesis and observe its efficacy in order to provide a new idea for the clinical treatment of diabetic gastroparesis.ObjectiveTo observe the improvement of symptoms of gastroparesis in patients with diabetic gastroparesis after treatment with doperidone and doperidone combined with epalrestat,and to evaluate the effects of the two treatment methods with Gastroparesis Cardinal Symptom Index(GCSI).MethodsCollecting endocrine department hospitalized diabetic patients in Huainan First People's Hospital from July 2015 to October 2018,64 patients in line with diabetic gastroparesis diagnostic criteria.All patients signed a written informed consent.The subjects were randomly divided into 2 groups:Group A(domperidone group)30,of which 6 male cases,24 female cases,average age(49.37± 17.25)years old;Group B(domperidone+epalrestat group)34,6 male cases,28 female cases,average age(48.71 ± 15.7)years old.The two groups,A and B,were treated with domperidone and domperidone combined with epalrestat respectively for 4 weeks,and the difference of curative effect between the two treatment methods was evaluated by GCSI-DD.The serum gastrin-17 level was determined by enzyme-linked immunosorbent method,and the level of gastrin-17 was observed in the treatment of A and B groups.The measurement data in the experimental data is represented by the mean ± standard deviation while the counting data is represented by the number of examples(percentage).The data processing is analyzed by SPSS 12.0 statistical software,and the p<0.05 is statistically significant.Results(1)After 4 weeks' treatment with domperidone and domperidone combined with epalrestat respectively,the results showed that although the score of the patients in group A with nausea,upper abdominal pain syptoms is not statistically different from groupB(P=0.053,0.100),the score of patients in group B with early fullness,after-dinner fullness and vomiting syptoms is not only significantly lower than group A(Two groups have statistically different scores of early fullness,after-dinner fullness and vomiting.P=0.012,<0.01,0.041),but also the GCSI-WD comprehensive score is obviously lower than group A.There are statistical differences between the two groups.(P=0.001).(2)The serum gastrin-17 level in A,B two groups treated by domperidone and domperidone combined with epalrestat respectively is both lower than before the treatment,and Group B after the treatment by domperidone combined with epalrestat is more obviously decreased(There was a statistical difference between the two groups,P<0.01).ConclusionThe treatment of diabetic gastroparesis with domperidone combined with epalrestat can significantly improve the main symptoms of gastroparesis,which is better than the treatment of domperidone alone.