埃索美拉唑与瑞巴派特联合使用在预防非甾体抗炎药相关性胃黏膜损伤中的疗效研究

Esomeprazole Combined with Rebamipide in Preventing Gastric Mucosal Lesions Induced by Non-steroidal Anti-inflammatory Drugs

目的评价埃索美拉唑与瑞巴派特联合使用与单用H2受体阻断剂、质子泵抑制剂及黏膜保护剂在预防非甾体抗炎药(NSAIDs)相关性胃黏膜损伤中的疗效。方法将2010年10月—2012年8月我院收治的138例规律服用NSAIDs的患者根据用药不同分为对照组23例、法莫替丁组26例、埃索美拉唑组28例、瑞巴派特组27例、埃索美拉唑+瑞巴派特组(埃+瑞组)34例,4周后对各组患者胃黏膜损伤临床表现的发生率及胃黏膜损伤程度评估异常的发生率进行比较分析。结果 5组患者胃黏膜损伤临床表现的发生率及胃黏膜损伤程度评估异常发生率比较,差异均有统计学意义(P<0.05)。其中法莫替丁组、埃索美拉唑组、瑞巴派特组及埃+瑞组胃黏膜损伤临床表现的发生率及胃黏膜损伤程度评估异常的发生率均较对照组低,且差异有统计学意义(P<0.05);法莫替丁组、埃索美拉唑组及瑞巴派特组患者胃黏膜损伤临床表现的发生率及胃黏膜损伤程度评估异常的发生率均较埃+瑞组高,且差异有统计学意义(P<0.05)。结论与单独应用H2受体阻断剂、质子泵抑制剂或黏膜保护剂相比,埃索美拉唑与瑞巴派特联合使用在预防NSAIDs相关性胃黏膜损伤中疗效更为显著。

Objective To assess the clinical efficacy of esomeprazole combined with rebamipide in preventing gastric mucosal lesions（GML） induced by non-steroidal anti-inflammatory drugs（NSAIDs）,and to compare with that of single use of H2-receptor antagonist,proton pump inhibitors or mucosal protective agents.Methods From October 2010 to August 2012,a totle of 138 patients taking NSAIDs were divided,according to their medication,into groups A（control group,n = 23）,B（using famotidine,n = 26）,C（using esomeprazole,n = 28）,D（using rebamipide,n = 27）,E（using esomeprazole and rebamipide,n = 34）.Incidences of upper gastrointestinal adverse reactions and GML were compared in the 5 groups after 4 weeks.Results There was significant difference in incidences of GML and abnormal GML evaluation in the 5 groups（P〈 0.05）,thereinto groups B,C,D,E had lower incidences than control group,the difference was significant（P〈 0.05）;Groups B,C,D had higher incidences than group E,the difference was significant（P〈 0.05）.Conclusion Esomeprazole combined with Rebamipide is of remarkable effect in prevention of NSAIDs-related GML as compared with single-use of H2 receptor antagonist,proton pump inhibitors or mucosal protective agents.