瑞巴派特联合泮托拉唑治疗幽门螺杆菌阴性慢性糜烂性胃炎的临床疗效研究

The efficacy of rebamipide joint pantoprazole for patients with Helicobacter pylori-negative chronic erosive gastritis

目的观察瑞巴派特联合泮托拉唑治疗幽门螺旋杆菌(Hp)阴性慢性糜烂性胃炎患者的临床疗效。方法选取Hp阴性慢性糜烂性胃炎患者216例,依据分层随机分组法将患者分为治疗组及对照组,每组108例。给予对照组瑞巴派特联合硫糖铝进行治疗,治疗组在对照组治疗方案基础上加用泮托拉唑进行治疗。观察比较两组患者治疗前后糜烂组织的丙二醛(MDA)、前列腺素E2(PGE2)含量、临床症状消失时间、餐后饱胀、反酸、嗳气、不规则性腹痛及大便潜血阳性例数以及治疗8周期间并发贫血、腹泻、胃溃疡、严重消化道出血例数及不良反应情况。结果治疗前两组患者胃黏膜的MDA、PGE2含量、餐后饱胀、反酸、嗳气、不规则性腹痛及大便潜血阳性例数比较差异无统计学意义(P>0.05);治疗后治疗组患者餐后饱胀、反酸、嗳气、不规则性腹痛及大便潜血阳性例数均明显少于对照组(P<0.05);治疗期间治疗组患者出现贫血、腹泻及胃溃疡例数明显少于对照组,治疗组患者的便秘例数(8例,6.90%)多于对照组(1例,0.93%)例,差异有统计学意义(P<0.05)。结论瑞巴派特联合泮托拉唑可显著改善慢性糜烂性胃溃疡患者临床症状,降低治疗期间不良事件发生率,临床疗效较为满意,对引发便秘的患者需要针对性处理。

Objective To explore the efficacy of rebamipide joint pantoprazole for patients with Helicobacter pylori（ Hp）-negative chro-nic erosive gastritis. Methods From March 2011 to January 2013,216 cases of Hp-negative chronic erosive gastritis treated in our hospital were divided into treatment group（n=108）and control group（n=108）according to the stratified randomization. The patients of control group were given rebamipide joint sucralfate for treatment and the patients of treatment group were given pantoprazole in addition to the treatment of control group. Malondialdehyde（MDA）and prostaglandin E2（PGE2）levels in the erosion tissue,disappearance time of symptoms,postprandial full-ness,acid reflux,belching,abdominal pain and irregular fecal occult blood positive cases before and after treatment in the two groups were com-pared. The concurrent anemia,diarrhea,gastric ulcer,the number of cases of serious gastrointestinal bleeding and adverse reactions during the eight weeks of treatment were also observed. Results There were no statistically significant differences in MDA and PGE2 levels,and the inci-dences of postprandial fullness,acid reflux,belching,irregular abdominal pain and fecal occult blood before treatment（ P 〉0. 05）between two groups. However,the incidences of postprandial fullness,acid reflux,belching,irregular abdominal pain and fecal occult blood of treatment group were significantly lower than those of the control group after the treatment（ P 〈0. 05）. The number of patients with anemia,diarrhea and peptic ulcer in the treatment group was significantly lower（ P 〈0. 05）;but the number of patients with constipation in treatment group（8,6. 90%） was significantly higher than control group（1,0. 93%）（ P 〈0. 05）during the treatment. Conclusion Rebamipide joint pantoprazole can sig-nificantly improve clinical symptoms and reduce adverse reactions in patients with chronic erosive stomach ulcer. Specific treatment is needed for patients who have constipation after the treatment.