title: Combination of symptoms, syndrome and disease: treatment of refractory diabetic gastroparesis.
abstract: OBJECTIVE
  To assess effect of combination of symptoms, syndrome and disease on treatment of diabetic gastroparesis with severe nausea and vomiting.
  
  
  METHODS
  Professor Tong Xiaolin's clinical electronic medical records of patients who were treated between January 1, 2006 and October 1, 2012 were used as a database. Patients who met the inclusion criteria were enrolled. General information (name, sex and age), symptoms and blood glucose levels were obtained from the clinic electronic medical record, which was supplemented by a telephone interview. The patient-rated Gastroparesis Cardinal Symptom Index (GCSI) was used to evaluate the severity of the symptoms of gastroparesis. The effects of the treatment were assessed by the change in the severity of the symptoms of gastroparesis and the change in blood glucose between the baseline levels and the post-treatment levels at 1, 2, 4, 8 and 12 wk.
  
  
  RESULTS
  Forty-five patients had a mean GCSI nausea and vomiting severity score of 4.21 ± 0.67 and a total GCSI score of 2.77 ± 0.63 before treatment. There was a significant improvement in the nausea and vomiting score at every return visit compared with the baseline score (1 wk: 3.02 ± 1.04 vs 4.18 ± 0.71, P < 0.001; 2 wk: 2.32 ± 1.25 vs 4.16 ± 0.73, P < 0.001; 4 wk: 2.12 ± 1.26 vs 4.12 ± 0.73, P < 0.001; 8 wk: 1.79 ± 1.09 vs 4.24 ± 0.77, P < 0.001; 12 wk: 0.69 ± 0.92 vs 4.25 ± 0.70, P < 0.001). Twenty-five of the 45 patients had complete resolution of vomiting during the observation period (mean time to resolution was 37.9 ± 27.3 d). The postprandial fullness and early satiety subscale, bloating subscale and total GCSI scores were also improved. Finally, the blood glucose levels improved after treatment, although the change was not significant.
  
  
  CONCLUSIONS
  Use of the combination of symptoms, syndrome and disease to treat diabetic gastroparesis with refractory nausea and vomiting may be a new treatment option.
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Jun-Ling
authors.initials: JL
authors.lastname: Li
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Pang
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Jia-Xing
authors.initials: JX
authors.lastname: Tian
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Hong-Xing
authors.initials: HX
authors.lastname: Liu
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Xi-Yan
authors.initials: XY
authors.lastname: Zhao
authors.affiliation: Jun-Ling Li, Bing Pang, Qiang Zhou, Xi-Yan Zhao, Xiao-Lin Tong, Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Tong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002681:China; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D018589:Gastroparesis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology
chemical_list: D000932:Antiemetics; D015415:Biomarkers; D001786:Blood Glucose; D004365:Drugs, Chinese Herbal; D007004:Hypoglycemic Agents
keywords: Diabetic gastroparesis; Gastroparesis Cardinal Symptom Index; Refractory nausea and vomiting; Traditional Chinese medicine; Treatment