Simethicone administration improves efficacy and efficiency of esophagogastroduodenoscopy

Abstract

Background: Esophagogastroduodenoscopy is very useful in diagnosing and treating upper gastrointestinal mucosal disorders, but too much foam and water in stomach decrease its diagnostic efficiency. Simethicone administration can help remove excessive foam. Aims: To determine the optimal simethicone administration strategies in a comparative randomized controlled clinical trial.Methods: Adult outpatients with indications for esophagogastroduodenoscopy were enrolled and randomly divided into Group 1 (simethicone solution intake 20-30 min before procedure, n=110), Group 2 (simethicone solution intake 31-60 min before procedure, n=92) and Group 3 (simethicone solution intake >60 min before procedure). Primary and secondary outcome were procedure time and the patients' satisfaction after the examination. All symptoms like abdominal pain, distension were recorded.Results: No statistically significant differences were found on the patients’ demographic and clinical features, and mean examination time (all P values >0.05). The distribution of patients with different endoscopic and pathological diagnosis was comparable among three groups, respectively (P=0.607; P=0.289). However, the proportion of patients with Gastric Cleanness Grade A was most in Group 2 (n=73, 79.3%), and patient proportion with Gastric Cleanness Grade C was most found in Group 1 (n=72, 65.5%), which was greatly different (P<0.001). There was no statistically significant difference on the satisfaction scores [immediately 6 (3-8) vs. 6 (1-10) vs. 6 (1-9), P=0.533; 2h after 10 (8-10) vs. 10 (10-10) vs. 10 (8-10), P=0.463].Conclusion: Simethicone solution intake 31-60 min before esophagogastroduodenoscopy can help obtain best gastric cleanness, which is recommended in clinical practice (registered at ClinicalTrials.gov, NCT03776916).

Effectiveness of Peng’s Shengjing recipe on male asthenospermia caused by kidney yang deficiency

“…9,12,13 Shengjing recipe also improved grade A and A+B sperms, and to a greater extent than in the Xuanju capsule group. These results are supported by Sun et al, 11 who showed 16 showed that Shengjing recipe could improve sperm density and motility, and increase the pregnancy rate. Similar results were observed by Song et al, 17 Guo et al, 18 Zhang et al, 19 and Chen et al 20 These effects are also supported by animal studies that shed some light on the mechanisms of Shengjing recipe.…”

“…The above drugs were used together to enhance the effect of sperm production. 11 In the present study, Xuanju capsule, a classical TCM for male infertility, was used as positive control and showed improvements in grade A and A+B sperms. 9,12,13 Shengjing recipe also improved grade A and A+B sperms, and to a greater extent than in the Xuanju capsule group.…”

“…7,8 Peng's Shengjing recipe is mainly composed of the Mantis Egg-case, hive, rigid silkworm, burnt astragalus, codonopsis, atractylodes, rehmannia, cornus, and Yizhiren. 11 The above drugs were used together to enhance the effect of sperm production. Sun et al 11 showed that Peng's Shengjing recipe could improve the parameters of asthenospermia.…”

“…11 The above drugs were used together to enhance the effect of sperm production. Sun et al 11 showed that Peng's Shengjing recipe could improve the parameters of asthenospermia. Basic experiments suggested that this effect might be related to the up-regulation of gonadotropins, including follicularstimulating hormone )FSH( and testosterone )T(.…”

“…Basic experiments suggested that this effect might be related to the up-regulation of gonadotropins, including follicularstimulating hormone )FSH( and testosterone )T(. 11 Research is necessary to determine the benefits of Peng's Shengjing recipe in treating male asthenospermia.…”