비폐색성 위 전정부 확장이 있는 흰쥐의 위 수축력, 체중 및 위 형태 복원에 대한 영계출감탕과 보중익기탕(補中益氣湯)의 효능

Effect of Youngkaechulgam-tang and Bojoongikki-tang on Gastric Contractility, Body Weight, and Gastric Morphology in Rats with Non-obstructive Antral Dilation

  • 정용재 (경희대학교 한의과대학 비계내과학교실) ;
  • 윤상협 (경희대학교 한의과대학 비계내과학교실)
  • Jung, Yong-Jae (3rd Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Hee University) ;
  • Yoon, Sang-Hyub (3rd Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Hee University)
  • 발행 : 2010.12.30

초록

Objectives : The aim of this study was to evaluate whether rats with non-obstructive antral dilation could be a useful tool resembling functional dyspeptic patients. We also investigated the effect of Bojoongikki-tang (BJ), and Youngkaechulgam-tang (YK) in antral dilated rats. Methods : Non-obstructive antral dilation was performed by first wrapping a non-absorbable rubber ring (D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum causing pyloric obstruction (PO). After 12 weeks, except for some PO group rats used for the control, the rubber ring was removed by performing another operation. The antral dilated rats (AD) were then divided into three groups, a non-treatment group (AD-NT), and two herbal medicine groups each given an extract solution containing 125 mg/kg of Youngkaechulgam-tang (AD-YK) or Bojoongikki-tang (AD-BJ) for 4 weeks. Then gastric contractility was evaluated by bowel sound measurement, and afterwards the changes of the weight, and morphologic changes of the stomach were evaluated for each group including the normal intact group (NI). Results : Loss of weight and enlargement of the stomach surface area was seen in the PO group. Decrease of gastric motility index was observed in the AD-NT group, while the increased surface area of the stomach was not significantly different from the PO group. Youngkaechulgam-tang seemed to increase gastric contraction, whereas Bojoongikki-tang showed no effect. Weight gain of rats was observed in both the AD-YK and AD-BJ groups, but there seemed to be no change of the dilated stomach surface area. Conclusions : The non-obstructive antral dilated rat seems to be an experimental pathologic model that reflects the gastric dysmotility similar to functional dyspeptic patients with antral dilation. Therefore patients with dysmotility-like dyspepsia with antral function disorders should be treated efficiently. As Youngkaechulgam-tang is shown to increase both gastric contraction and weight in antral dilated rats, it may be used for treating functional dyspepsia. However, Bojoongikki-tang should be used with caution in patients with gastric dysmotility.

키워드

참고문헌

  1. Yang SY, Lee OY, Kim HE, Chang YK, Yoon BC, Choi HS et al. Dietary related risk factors and quality of life in patients with gastroesophageal reflux disease. Korean J Med. 2006;70:627-35.
  2. 이풍렬, 이종철, 류광현, 김영호, 손희정, 김재준 등. Dyspepsia 를 주소로 내원한 환자들의 원인에 대한 고찰. 대한소화관운동학회지. 1998;4(2):112-7.
  3. 이광재. 기능성 소화불량증의 병태생리와 치료. 대한 소화관 운동학회지. 2003;9:85-91.
  4. Loreno M, Bucceri AM, Catalano F, Muratore LA, Blasi A, Brogna A. Pattern of gastric emptying in functional dyspepsia. An ultrasonographic study. Dig Dis Sci 2004;49:404-7.
  5. Hausken T, Berstad A. Wide gastric antrum in patients with non-ulcer dyspepsia. Effect of cisapride. Scand J Gastroenterol 1992;27:427-32. https://doi.org/10.3109/00365529209000100
  6. Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labo G. Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology 1985;89:752-59.
  7. Pallotta N, Pezzotti P, Corazziari E. Relationship between antral distension and postprandial symptoms in functional dyspepsia. World J Gastroenterol. 2006;12(43):6982-91.
  8. Riezzo G, Chiloiro M, Guerra V, Borrelli O, Salvia G, Cucchiara S. Comparison of gastric electrical activity and gastric emptying in healthy and dispeptic children. Dig Dis Sci. 2000;45(3):517-24. https://doi.org/10.1023/A:1005493123557
  9. Fujimiya M, Asakawa A, Ataka K, Kato I, Inui A. Different effects of ghrelin, des-acyl ghrelin and obestatin on gastroduodenal motility in conscious rats. World J Gastroenterol. 2008;14(41):6318-26. https://doi.org/10.3748/wjg.14.6318
  10. 花輪壽彦 著, 조기호, 주용희, 김성준 譯. 한방진료의 LESSON. 서울: 고려의학; 2001, p. 113.
  11. Ohno T, Mochiki E, Kuwano H. The roles of motilin and ghrelin in gastrointestinal motility. Int J Pept. Epub 2010;2010 article ID 820794
  12. 한숙영, 윤상협. 二陳湯이 정상 및 위 유문부가 부분폐색된 흰 쥐의 위 운동성에 미치는 효과. 대한한방내과학회. 2009;30(1):107-18.
  13. 김진석, 윤상협. 內消散의 정상 및 위 유문부 확장 흰 쥐의 위 운동성에 대한 효능. 대한한방내과학회. 2008;29(1):117-29.
  14. 홍인아, 윤상협. 족삼리혈 전침 자극이 유문부 부분폐색이 된 흰 쥐의 위 배출능에 미치는 효능. 대한한방내과학회. 2009;30(1):1-8.
  15. 노의준, 강한은. 고방유취. 서울: 복치의학회출판국; 2009, p. 195.
  16. 조기호 외 13인. 임상 한방의학. 서울: 신훙메드싸이언스; 2009, p. 41.
  17. 황황. 중의십대유방. 서울: 집문당; 2004, p. 161.
  18. 전국한의과대학 비계내과학교실. 비계내과학. 서울: 군자출판사; 2008, p. 348.
  19. 박영선, 윤상협. 補中益氣湯, 十全大補湯, 苓桂朮甘湯이 장음으로 평가된 흰 쥐의 胃 收縮力에 미치는 영향. 대한내과학회지. 2010;31(2):24-35.
  20. Omura N, Kashiwagi H, Aoki T. Changes in gastric hormones associated with gastric outlet obstruction. An experimental study in rats. Scand J Gastroenterol 1993;28:568-72. https://doi.org/10.3109/00365529309096089
  21. Cruz MT, Murphy EC, Sahibzada N, Verbalis JG, Gillis RA. A reevaluation of the effects of stimulation of the dorsal motor nucleus of the vagus on gastric motility in the rat. Am J Physiol Regul Integr Comp Physiol. 2007;292(1):291-307.
  22. 원종만, 윤상협. 六君子湯이 흰쥐의 胃 排出能에 미치는 영향. 대한한방내과학회. 2007;28(2):242-49.
  23. Ricci R, Bontempo I, La Bella A, De Tschudy A, Corazziari E. Dyspeptic symptoms and gastric antrum distribution. An ultrasonographic study. Ital J Gastroenterol. 1987;19:215-17.
  24. Avenhaus W, Kemper B, von Bally G, Donschke W. Gastric wall elasticity assed by dynamic endoscopy: ex vivo investigations in the porcine stomach. Gastrointest Endosc. 2001;54(4):496-500. https://doi.org/10.1067/mge.2001.118443
  25. Egorov V, Schastlivtev I, Prut E, Baranov A, Turusov R. Mechanical properties of the human gastrointenstinal tract. J Biomech. 2002;35(10):1417-25. https://doi.org/10.1016/S0021-9290(02)00084-2
  26. Kamino D, Manabe N, Hata J, Haruma K, Tanaka S, Chayama K. Long-term Ultrasonographic Follow-up Study of Gastric Motility in Patients with Functional Dyspepsia. J. Clin Biochem Nutr. 2008;42(2):144-9. https://doi.org/10.3164/jcbn.2008021
  27. 홍인아, 윤상협. 제목 기능성 소화불량증 환자의 위장관 부교감 신경, 위 유문부의 기능 및 임상양상에 대한 조사 (한방병원 내원 환자를 중심으로). 대한한방내과학회. 2008;29(3):666-74.
  28. 김유승, 윤상협. 기능성 소화불량증 환자의 위 미주신경 활성 및 유문부 기능에 대한 足三里 전침과 일반 체침 자극의 복합 효능. 대한한방내과학회. 2008;29(3):621-8.
  29. Tomomasa T, Morikawa A, Sandler RH, Mansy HA, Koneko H, Masahiko T et al. Gastrointestinal sounds and migrating motor complex in fasted humans. Am J Gastroenterol. 1999;94(2):374-81. https://doi.org/10.1111/j.1572-0241.1999.00862.x
  30. Yamaguchi K, Yamaguchi T, Odaka T, Saisho H. Evaluation of gastrointestinal motility by computerized analysis of abdominal auscultation findings. J Gastroenterol Hepatol. 2006;21(3):510-4. https://doi.org/10.1111/j.1440-1746.2005.03997.x
  31. 문영명. Patholphysiology로 이해하는 내과학, 소화기질환. 서울: 정담; 2002, p. 141-2.
  32. Troncon L, Bennet R, Thompson D. Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients. Gut. 1994;35:327-32. https://doi.org/10.1136/gut.35.3.327
  33. Matsuo H, Van Cutsem E, Wilmer A, et al. Impaired gastric compliance is related to weight loss in severe motility-like dyspeptic patients. Gastroenterology. 1994;106:A537.
  34. Le KJ, Kint S, Tack J. Pathophysiology of functional dyspepsia. Best Pract Res Clin Gastroenterol. 2004;18(4):707-16. https://doi.org/10.1016/j.bpg.2004.04.007
  35. 中山醫學院 著, 이상인, 안덕균, 신민교 譯. 한약임상응용. 서울: 성보사; 1982, p. 343-4.
  36. 張介賓. 景岳全書. 서울: 정담; 1999, p. 29, 307.
  37. 전국 한의과대학 본초학 교수. 본초학. 서울:영림사; 2000, p. 534, 579.
  38. 許浚. 東醫寶鑑. 서울: 동의보감출판사; 2005, p. 1201-89.