替普瑞酮联合叶酸治疗慢性萎缩性胃炎的临床观察

Treatment of chronic atrophic gastritis with teprenone and folic acid

目的观察替普瑞酮联合叶酸治疗慢性萎缩性胃炎（CAG）的临床疗效。方法选择经胃镜检查符合CAG诊断的患者60例，完全随机分为治疗组和对照组，各30例。治疗组予以替普瑞酮50mg，3次／d口服，叶酸10mg，3次／d口服；对照组予以维酶素1000mg，3次／d口服。疗程均为12周。分别于治疗前后观察腹胀、嗳气、上腹痛、上腹烧灼感等症状变化，并复查胃镜及活检，进行组织病理学改善的评估。结果治疗前后临床症状评分治疗组分别为（9．8±4．6）、（3．8±2．4）分，对照组分别为（9．6±4．3）、（6．4±3．1）分，治疗后2组临床症状总积分均下降，治疗组较对照组下降明显（t=3．562，P〈0．01）；治疗组组织病理学改善显效率为40．O％（12／30），好转率为50．0％（15／30），总有效率为90．O％（27／30）；对照组显效率为16．7％（5／30），好转率26．7％（8／30），总有效率为43．3％（13／30）（P〈0．01）。结论替普瑞酮联合叶酸治疗可有效改善CAG患者的临床症状和病理分级。

Objective To observe the clinical efficacy of teprenone and folic acid in treatment of chronic atrophic gastritis in order to develop an effective strategy to treat the disease. Methods Sixty cases of chronic atrophic gastritis diagnosed with gastroendoscopy were randomized into treatment group （ receiving teprenone and folic acid, Teprenone 50 mg, tid, folic acid 10 mg, tid） and control group （ receiving oral Vitacoenzyme Tablets, 1000 mg, tid） with 30 cases in each group. Both groups received a treatment cause of 12 weeks. Evaluation was performed for the symptoms, such as bloating, belching, epigastric pain and epigastric burning sensation. Gastroendoscopic and pathological evaluations by biopsy were also performed. Results The scores of the treatment group before and after receiving drugs were （9. 6 ＋ 4. 3 ） and （6.4 ＋ 3.1 ） points. The scores for the clinical symptoms were descreased in both of the groups. The group receiving combinational treatment got work symptom improvement more significant than the control group （ t = 3. 562, P 〈 0. 01 ）. Fifty percent of the patients got an improvement and fourty percent of the patients got an pathological improvement. The response rate was 90. 0%. In the control group, the complete response rate was 16.7% and the partial response rate was 26. 7%, with a total resonse rate of 43.3% （ P 〈 0. 01 ）. Conclusion Combinational treatment with teprenone and folid acid is effective to improve the symptoms and natholo^ical made of chronic atronhic gastritis.