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호기수소측정법을 이용한 Cisapride 와 Tiropramide 의 구강 - 맹장 배출시간의 영향
임영국(Young Guk Lim),정태홍(Tat Hong Jung),조희충(Hee Choong Cho),김원식(Won Sik Kim),정종훈(Jong Hoon Chung),정춘해(Choon Hae Chung),박찬국(Chan Gook Park),김만우(Man Woo Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.5
N/A Objectives: A few gastroenterologists would underrate the importance of gastrointestinal motility in the pathogenesis of gut symptoms, particularly as the majority of clinic patients have functional symptoms. The aim of the present study was to determine whether changes in oral to cecal transit time affect the magnitude of the hydrogen (H2) excretion after ingestion of unabsorbable carbohydrate. The lactulose H2 breath test is in use as a simple non-invasive measurement of oral to cecal transit time and its reproducibility. The effect of tiropramide hydrochloride and cisapride on oral to cecal transit time have been compared in a placebo-controlled study. Methods: This studies including forty-one healthy volunteers by interval sampling of end expiratory H2 concentration after ingestion of: (1) 10 g lactulose with placebo; (2) 10 g lactulose with tiropramide hydrochloride (Tiropa®); (3) 10 g lactulose with cisapride (Prepulside®). A minimum of six days elapsed between the difference tests to avoid colonic bacterial metabolic changes. Results: The oral to cecal transit time (OCTT) measured by placebo ingestion, tiropramide and cisapride were 90.24±28.33, 102.44±31.37 and 83.41±27.17 minutes. A short of OCTT in cisapride ingestion showed significance compared with the placebo, tiropramide (p<0.0005). Area under curve (AUC) of the H2 concentration versus time curves from the OCTT after ingestion of placebo, tiropramide and cisapride were 35.50±24.35, 33.78±24.28, 45.65±26.04 (ppm×min×100), respectively. A rise of AUC in cisapride ingestion showed no significance compared with the placebo, tiropramide. Conclusion: The present findings indicate that changes of the OCTT do not significantly influence the H2 excretion as measured by interval sampling of end expiratory H2 concentrations after different drugs. In conclusion, within the ranges observed, the OCTT does significantly affect the shape of the H2 concentration after ingestion of differential drug.
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