Efficacy of itopride combined with alpha-lipoic acid for patients with diabetic gastroparesis

Abstract

Objective To evaluate the efficacy of itopride hydrochloride combined with alpha-lipoic acid in treatment of diabetic gastroparesis. Methods One hundred and ten patients with diabetic gastroparesis were randomly assigned to two groups. Sixty patients received α-lipoic acid plus itopride (α-lipoic acid 0.6 g intravenously for 14 d plus itopride 50 mg orally t. i.d), and 50 cases received oral itopride only.The clinical symptoms including postprandial abdominal fullness, belching, acid reflux, anorexia, nausea and vomiting were observed; the gastric emptying rate was tested, and plasma motilin and serum ganstrin levels were measured groups, before and after two weeks of treatment. Results The clinical symptom scores of combination therapy group (4.62±3.46 vs. 12.26±3.43) and control groups (5.43±3.65 vs. 12.31±3.37) were improved after treatment. The overall effective rate of combination group was 91.6% and that of itopride therapy group was 78.0% (χ2=4.098, P<0.05). Gastric emptying rate of combination group [(76.9±9.7)% vs. (37.3±10.2) %] was increased more markedly than that of itopride group[(57.2±10.4)% vs. (36.8±11.2)%] (t=10.221, P<0.05). Plasma motilin and serum ganstrin levels in combination group [(640.2±64.4)ng/L vs. (554.0±67.6)ng/L, (152.6±20.3)ng/L vs. (96.8±22.2)ng/L] were reduced more markedly than those in itopride group [(636.3±66.4)ng/L vs. (589.4±48.3)ng/L, (153.5±19.4)ng/L vs. (120.9±19.7)ng/L] respectively (t=3.100, 5.959, all P<0.05). Conclusion For patients with diabetic gastroparesis, α-lipoic acid and itopride combination therapy can significantly improve symptoms and gastric emptying rate, decrease motlin and gastrin levels; and the efficacy of combination therapy is better than that of itopride monotherapy. Key words: Diabetes mellitus; Gastroparesis; Tiapride; Thioctic acid