腸液検査法

EXAMINATION METHODS OF SUCCUS ENTERICUS

Ⅰ．はじめに

　消化吸収に関する研究法としては，わが国では主として吸収試験法，とくに各種栄養素の摂取量と排泄量を測定して，その比から吸収率を算出するBalance studyや，特定の物質を経口投与した後の血中濃度や尿中排泄量から腸管吸収能をみる方法が臨床上広く用いられている．しかしながら，これらの検査法は腸管内の消化吸収を間接的に知る方法であるから，より直接的に挿管法によって得られた腸内容物について，構成成分や酵素活性を測定することが重要であることはいうまでもない．古くEinhornが十二指腸ゾンデを考案して，十二指腸液を採取したのが腸液検査法の最初ではあるが，1934年MillerらがMiller-Abbott管を作成して，下部小腸からも腸液を採取する方法を確立したのを契機に，腸液検査法は著しい発展をとげた．ここでは今日までの腸液検査法の発展のあらましを，われわれの研究と併せて述べることにする．

　For studying digestion and absorption in all their phases, various examination methods have been employed in this country, such as balance study in which the rate of absorption is measured by comparing the amount of some specific ingredients like fat or protein in the diet administered with their amount in the stool; or its simplified method, viz., the study of absorption by introducing radioactive isotope; or estimation of the amount of a specific substance excreted in the urine or contained in the blood. All these procedures, however, are devious in learning the mechanism of digestion and absorption in the intestine. Examination of intestinal secretion itself, measuring its hydrolyzed debris and the activity of its enzymes by means of a canule inserted in the small bowel, through which succus entericus is freely obtained, is a far more direct and appropriate measure.

　In this paper is first described the achievements of T. G. Miller, the originator of direct method for studying intestinal secretion; and secondly, the significance of reference substance, or nonabsorbable marker, is discussed. A practicable method of examination is further described of introducing a nonabsorhable marker in the study of intestinal secretion, in order to investigate the mechanism of absorption of such substances as water, electrolytes, carbohydrate and so forth. Next a recent research method for the study of intestinal absorption is explained, which is a way to investigate intestinal absorption of fat and formation of micellar phase by administering extra amount of fat, together with the results obtained by the authors. A concise description is finally given as to the significance of recent examination methods of intestinal secretion as they are employed for elucidation of absorptive mechanism of fat in the intestine.