替普瑞酮联合叶酸治疗慢性萎缩性胃炎的疗效观察

The Observation of Curative Effect of Teprenone and Folic Acid in Treatment of Chronic Atrophic Gastritis

目的探讨分别采用替普瑞酮联合叶酸、单用叶酸及胃复春3种药物方案治疗慢性萎缩性胃炎的临床疗效。方法选取2013年4月-2015年1月于福建师范大学医院经电子胃镜检查确诊的147例慢性萎缩性胃炎患者作为研究对象,随机分成替普瑞酮联合叶酸治疗组（以下简称联合治疗组）、叶酸组及胃复春组,每组49例。治疗时间为6个月,比较3组患者治疗后临床症状、胃镜下黏膜病变的改善情况及病理组织学变化情况。结果 3组患者的上腹痛、腹胀、反酸、嗳气等症状均有缓解,联合治疗组对上述症状的总有效率分别为83.3%,87.2%,79.1%,80.0%,均高于叶酸组和胃复春组,且3组比较差异均有统计学意义（P〈0.05）;治疗后,在胃镜下黏膜病变改善方面,联合治疗组患者的总有效率为93.9%,叶酸组患者的总有效率为61.2%,胃复春组患者的总有效率为79.6%,3组比较差异有统计学意义（χ~2=18.04,P〈0.05）;治疗后,在病理学组织学方面,联合治疗组患者的总有效率为87.8%,叶酸组患者的总有效率为59.2%,胃复春组患者的总有效率为71.4%,3组比较差异有统计学意义（χ~2=10.44,P〈0.05）。结论替普瑞酮联合叶酸治疗慢性萎缩性胃炎的临床疗效显著,值得临床推广。

Objective To explore clinical efficiency of combination therapy of teprenone and folic acid, folic acid alone and Weifuchun in patients with chronic atrophic gastritis. Methods The study was performed on the clinical data of 147 patients with chronic atrophic gastritis who were confirmed by electronic gastroscopy in hospital of Fujian Normal University from April 2013 to January 2015. These patients were randomly divided into combined treatment group of teprenone and folic acid, treatment group of folic acid, and treatment group of Weifuchun with 49 persons in each one. After 6 months treatment, symptom changes were compared in terms of clinical symptoms, mucosal lesion under gastroscopy and histopathology. Results All of 3 treatments had an alleviative effect on symptoms of epigastric pain, abdominal distension, sour regurgitation and belching. The ratio of curative efficiency of combined treatment group on above symptoms （83.3% ,87.2%,79.1% and 80.0%） were higher than that of other 2 groups. The difference is statistically significant（P〈0.05）when com- paring 3 groups. Symptom of mucosal lesion mitigated after treatment, manifesting 93.9 % curative efficiency for combine treatment group, 61.20%curative efficiency for folic acid group, and 79.6 % curative efficiency for Weifuchun group. The difference is statistically significant （x2= 18.04,P〈0.05）. In terms of histopathology after treatment, the proportion of curative efficiency of combine treatment group was 87.8%, the rate of cura- tive efficiency of folic acid group was 59.2%, and the ratio of curative efficiency of Weifuchun group was 71.4%. The difference is statistically significant （x2 =10.44,P〈0.05）. Conclusion Combination treatment of teprenone and folic acid has a significant clinical effect on chronic atrophic gastritis, which is worthy to be pop- ularized.