柏西消化应用课件.ppt

1、According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西消化科应用柏西消化科应用（西甲硅油乳剂）（西甲硅油乳剂）德国柏林德国柏林-化学股份公司化学股份公司ESPUMISENAccording to the assessment requireme

2、nts of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline消化科的患者消化科的患者70-80%都会伴都会伴有腹胀的症状，一般医生可能直接考有腹胀的症状，一般医生可能直接考虑的是动力障碍，会应用一些促动力虑的是动力障碍，会应用一些促动力剂进行治疗。今天给大家介绍一个崭剂进行治疗。今天给大家介绍一个崭新的途径解决胀气和其他相关症

3、状的新的途径解决胀气和其他相关症状的药物药物-柏西！柏西！柏西是德国进口的专业排气剂！柏西是德国进口的专业排气剂！前言前言According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline目目 录录q气体吸收和排泄的生理过程气体吸收和排泄的生理过程q术后腹胀的

4、发病机理术后腹胀的发病机理q柏西的作用机理柏西的作用机理q柏西产品信息柏西产品信息q柏西临床验证柏西临床验证q柏西产品特点柏西产品特点According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline胃肠道气体的产生吞咽的空气吞咽的空气胃酸的中和作用胃酸的中和

5、作用从血液弥散到小肠从血液弥散到小肠细菌代谢细菌代谢According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline胃肠道气体的排泄嗳气打嗝嗳气打嗝弥散入血弥散入血细菌代谢细菌代谢肛门排气肛门排气According to the assessment req

6、uirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline气体积聚的原因(一)腹部气体增多腹部气体增多吞气症吞气症产气增加产气增加胃肠蠕动障碍胃肠蠕动障碍气体吸收减少气体吸收减少神经官能症神经官能症不良饮食习惯不良饮食习惯气管造口气管造口气管内麻醉气管内麻醉腹部手术腹部手术结肠菌群分结肠菌群分解底物增多解底物增多

7、细菌过度细菌过度增值增值右心衰右心衰门静脉高门静脉高压压 肠无力肠无力抗生素治抗生素治疗疗IBS胃肠麻痹胃肠麻痹According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline腹部增多的气体是以不活动的泡沫状态存在腹部增多的气体是以不活动的泡沫状态存在的。即

8、胃肠道分泌的粘液，将气体包裹，阻的。即胃肠道分泌的粘液，将气体包裹，阻止气体的吸收和排除。止气体的吸收和排除。术后腹胀原因（二）According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline发病机理发病机理气体积聚气体积聚气体以泡沫状态气体以泡沫状态存在，

9、不易排泄存在，不易排泄胃肠道气体增多胃肠道气体增多腹胀、恶心、呕吐、反酸、腹胀、恶心、呕吐、反酸、腹痛，早饱，食欲不振腹痛，早饱，食欲不振According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline作用机理作用机理q柏西柏西n降低气泡表面张力，促使气泡破

10、裂，使降低气泡表面张力，促使气泡破裂，使气体释放出来，一部分随肠道蠕动排泄，气体释放出来，一部分随肠道蠕动排泄，一部分被消化道吸收，从而达到治疗消一部分被消化道吸收，从而达到治疗消化道胀气的目的。化道胀气的目的。According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-d

11、iscipline直接作用气体，加速气体排出直接作用气体，加速气体排出Ivan E.Danhof,PhD,simethicone accelerate the eliminate of gas,Obstetrics and Gynecology 1974;vol.44According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise

12、leaders integrity and self-disciplinesimethicone西甲硅油西甲硅油活性成分活性成分silica二氧化硅二氧化硅4-7%dimethicone二甲硅油二甲硅油+v减低表面张力减低表面张力v纯物理特性纯物理特性药理学和生理学药理学和生理学惰性物质。惰性物质。乳白色均匀的乳剂，略带香蕉味乳白色均匀的乳剂，略带香蕉味摘自摘自欧洲药典欧洲药典According to the assessment requirements of party conduct and clean government,combined with the five regulati

13、ons and five new requirements of state-owned Enterprise leaders integrity and self-discipline西甲硅油与二甲硅油区别西甲硅油与二甲硅油区别q二甲硅油和二氧化硅单独应用只是弱二甲硅油和二氧化硅单独应用只是弱的消泡的作用，当两者混合之后，混的消泡的作用，当两者混合之后，混合物非常有效。合物非常有效。q应用混合物（二甲硅油应用混合物（二甲硅油+二氧化硅二氧化硅5mg）就能达到）就能达到750mg二甲硅油的二甲硅油的作用。作用。The effect of free silica on the mucosal p

14、rotective and antiflatulent properties of polydimethylsiloxane Pharm.pharmac.,1973,25,859-863According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西柏西

15、-药理学研究药理学研究西甲硅油的作用是二甲硅油的西甲硅油的作用是二甲硅油的150倍倍出处：R.D.N.BIRTLEY,The effect of free silica on the mucosal protective and antiflatulent properties of polydimethylsiloxane,Pharm.Pharmac.1973,25,859-863According to the assessment requirements of party conduct and clean government,combined with the five regul

16、ations and five new requirements of state-owned Enterprise leaders integrity and self-discipline德国工艺，纳米技术德国工艺，纳米技术西甲硅油颗粒在西甲硅油颗粒在8-10纳米之间纳米之间According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enter

17、prise leaders integrity and self-discipline毒理学研究毒理学研究l急性毒性试验急性毒性试验 大鼠口服西甲硅油大鼠口服西甲硅油LD50为为34.6g/kg，相当于人体口服，相当于人体口服剂量的剂量的25950倍，倍，未观察到毒性反应。未观察到毒性反应。l长期毒性试验长期毒性试验 0.3%的的西甲硅油喂饲给鼠西甲硅油喂饲给鼠长达长达2年年，未观察到毒性反，未观察到毒性反应。应。l生殖毒性试验生殖毒性试验 口服和皮下给予西甲硅油后对口服和皮下给予西甲硅油后对生殖能力、胎儿毒性或生殖能力、胎儿毒性或产生畸胎产生畸胎无任何副作用。无任何副作用。According

18、 to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline安全性研究安全性研究q纯物理作用，没有涉及化学反应纯物理作用，没有涉及化学反应q毒理试验表明，无任何毒性毒理试验表明，无任何毒性q物理学和生理学惰性物质，不与食物理学和生理学惰性物质，不与食物和药物发生反应物和药

19、物发生反应q不从胃肠道吸收，不产生系统毒性不从胃肠道吸收，不产生系统毒性q孕产妇，儿童和糖尿病患者均可安孕产妇，儿童和糖尿病患者均可安全服用全服用According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline适适 应应 症症q胃肠道气体积聚，引起的不适胃肠

20、道气体积聚，引起的不适n婴幼儿腹痛、腹胀婴幼儿腹痛、腹胀(过度哭闹过度哭闹)n手术后腹胀手术后腹胀n胃肠胀气胃肠胀气n消化不良消化不良q腹部图像诊断腹部图像诊断n胃肠道内镜检查胃肠道内镜检查n腹部超声摄影腹部超声摄影n放射线诊断放射线诊断According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integri

21、ty and self-discipline柏西有效治疗腹胀柏西有效治疗腹胀Bernstein JE,Kasich AM,J Clin Pharmacol 1974;14:617-623 有效降低功能性消化不良的患者腹胀的发生频率 入组人数入组人数According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders in

22、tegrity and self-discipline*：P0.0001#:P+O.0007柏西有效治疗功能性消化不良柏西有效治疗功能性消化不良西甲硅油在全面治疗功能性消化不良，并在治疗2周时优于西沙必利 G.HOLTMANN.Aliment Pharmacol Ther 2002;1641-1648According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-

23、owned Enterprise leaders integrity and self-discipline柏西有效治疗婴儿腹痛柏西有效治疗婴儿腹痛双盲安慰剂对照研究哭闹次数治疗天数*p 0.01;*p 0.02;#p 0.05 simeticone vs.placebo*#*：KANMALFIT S SETHI MB BS JASBIR K SETHI MB,Simethicone in the management of infant colic,the practitioner,9 May,1988,Vol 232,508According to the assessment requi

24、rements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline0 0101020203030404050506060治疗组治疗组(n=100)(n=100)对照组对照组(n=100)(n=100)未未发发生生腹腹痛痛的的患患者者(%)(%)n=200n=200柏西有效预防术后腹痛发生柏西有效预防术后腹痛发生P0.05Al

25、an Gibstein,Obstetrics and Gynecology,vol.44No.1 July 1974,386-390According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西有效预防术后腹胀发生柏西有效预防术后腹胀发生7575808

26、0858590909595100100治疗组治疗组(n=100)(n=100)对照组对照组(n=100)(n=100)n=200n=200P0.05Alan Gibstein,Obstetrics and Gynecology,vol.44No.1 July 1974,386-390未发生腹胀的患者未发生腹胀的患者%According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements o

27、f state-owned Enterprise leaders integrity and self-discipline65657070757580808585术术后后1 1至至2 2天天自自主主排排气气的的患患者者比比例例(%)(%)治疗组治疗组(n=100)(n=100)对照组对照组(n=100)(n=100)n=200n=20085%72%柏西缩短术后排气时间柏西缩短术后排气时间P0.05According to the assessment requirements of party conduct and clean government,combined with the fi

28、ve regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西治疗不完全性肠梗阻柏西治疗不完全性肠梗阻人 数Shyr-chyr chea,Nonsurgical management of patial adhesive small-bowel obstruction with oral therapy:a randomized controlled trialAccording to the assessment requirements of

29、 party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西改善柏西改善B超胰尾显像超胰尾显像Radiology 2000;217:780-785西甲硅油是腹部超声诊断的有效、安全、经济的选择According to the assessment requirements of party conduct and clean gove

30、rnment,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西有效改善胶囊镜清晰度柏西有效改善胶囊镜清晰度柏西组对照组显影清晰患者数%According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requ

31、irements of state-owned Enterprise leaders integrity and self-discipline西甲硅油在内镜胃体胃底观察中的价值吴云林吴云林 陈丽娜陈丽娜 等等上海交通大学瑞金医院消化科上海交通大学瑞金医院消化科According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise lea

32、ders integrity and self-discipline研究方法研究方法q研究组 206例例 平均年龄平均年龄 53岁岁 胃镜检查前胃镜检查前20西甲硅油西甲硅油30ml（柏西）（柏西）检查前检查前10利多卡因胶浆利多卡因胶浆10ml口服口服q对照组 232例例 平均年龄平均年龄54岁岁 胃镜检查前胃镜检查前10 利多卡因胶浆利多卡因胶浆10ml口口服服According to the assessment requirements of party conduct and clean government,combined with the five regulations an

33、d five new requirements of state-owned Enterprise leaders integrity and self-discipline评估指标：根据视野清晰度评估指标：根据视野清晰度qA级级 全胃无泡沫全胃无泡沫 视野清晰视野清晰qB级级 胃窦无泡沫胃窦无泡沫 视野清晰视野清晰qC级级 胃体、胃底及胃窦散见部分泡沫胃体、胃底及胃窦散见部分泡沫 视野受影响视野受影响qD级级 几乎所有胃黏膜表面附着多量泡沫几乎所有胃黏膜表面附着多量泡沫 冲洗后方能有效观察黏膜性状冲洗后方能有效观察黏膜性状According to the assessment require

34、ments of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline单用盐酸利多卡因胶浆胃底、单用盐酸利多卡因胶浆胃底、贲门部粘膜表面附着大量泡沫贲门部粘膜表面附着大量泡沫难以有效观察难以有效观察联用西甲硅油和盐酸利多卡因胶浆联用西甲硅油和盐酸利多卡因胶浆贲门贲门LLc凹陷性病灶明确可辨凹陷性病灶明确可辨 研究结果研究结果Acco

35、rding to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline研究结果研究结果吴云林，陈丽娜，艾普米森在胃底胃体观察中的价值，肝病胃肠病杂志。According to the assessment requirements of party conduct and

36、 clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西治疗功能性消化不良功能性消化不良功能性消化不良Hp阳性阳性清除清除Hp(治疗受益率：治疗受益率：10-30%)如果有症状则给予经验性如果有症状则给予经验性抗分泌治疗抗分泌治疗(治疗受益率：治疗受益率：30%)如果失败如果失败Hp阴性阴性如果有症状则给予经验性抗分泌治疗如果有症状则给予经验性抗分泌治疗(治疗受益率

37、：治疗受益率：30%)改变药物种类或使用更强效的抑酸药改变药物种类或使用更强效的抑酸药(治疗受益率：未知治疗受益率：未知)对受益未知的药物进行经验性研究对受益未知的药物进行经验性研究西甲硅油西甲硅油，硫糖铝，铋剂，抗痉挛药，硫糖铝，铋剂，抗痉挛药促动力药或抗抑郁药促动力药或抗抑郁药疗效未知的药物：疗效未知的药物：SSRIs，替加色罗，丁螺环酮，舒马坦，替加色罗，丁螺环酮，舒马坦Talley N.Rev in Gastro Disorders 2003;3:25According to the assessment requirements of party conduct and clean

38、government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline柏西在放射诊断的应用柏西在放射诊断的应用用药前用药后According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements

39、 of state-owned Enterprise leaders integrity and self-discipline用法用量用法用量q用于气体积聚引起的不适用于气体积聚引起的不适q儿童：2ml,3-5次/日q成年人：5ml,3-5次/日q用于显像检查用于显像检查q放射检查（输尿管显像）：检查前一天，5ml,tid,检查当日晨服15ml。q胃镜检查：检查前30分钟，顿服。儿童10ml/次，成人30ml/次。q胰尾及胆囊B超：检查前30分钟，顿服。q儿童10ml/次，成人30ml/次。According to the assessment requirements of party c

40、onduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline产品关键信息产品关键信息q安全！安全！q纯物理作用，无任何毒性。q物理学和生理学惰性物质，不与任何食物与药物发生反应q不被人体吸收，无系统性副作用q同样适用于婴幼儿、孕产妇和糖尿病人q高效！高效！q有效治疗由于气体积聚引起的不适：消化不良，腹胀症、胃心综合症，婴幼儿腹痛，术后腹胀等q有效提高腹部影像清晰度q是二甲硅油的150倍q耐受！耐受！q香蕉口味乳剂q德国工艺，纳米技术！德国工艺，纳米技术！According to the assessment requirements of party conduct and clean government,combined with the five regulations and five new requirements of state-owned Enterprise leaders integrity and self-discipline谢谢！谢谢！