曲美布汀在微创胆道术后胆汁反流性胃炎中的疗效研究

Curative effects of trimebutine on bile reflux gastritis caused by minimally invasive biliary surgery

目的:探讨曲美布汀在微创胆道术后胆汁反流性胃炎中的疗效。方法:选取我院2013年1月至2015年1月间确诊的微创胆道术后并发胆汁反流性胃炎79例,随机分为观察组(I组)和对照组(II组),其中I组(n=38)口服泮托拉唑钠肠溶片40mg qd+铝镁加混悬液15ml(1.5g)tid+马来酸曲美布汀片200mg tid;II组(n=41)口服泮托拉唑钠肠溶40mg qd+铝镁加混悬液15ml(1.5g)tid+多潘立酮片10mg tid。治疗8w后,观察上腹痛、腹胀、嗳气、烧心或胸骨后痛、恶心或呕吐等症状以及发作频度,并于第8周通过胃镜和空腹胃内容物PH值及甘胆酸含量的变化评价疗效。结果:治疗8w后两组患者腹胀、嗳气、烧心、上腹痛或胸骨后痛,以及恶心或呕吐等症状比较治疗前均得到有效缓解(P<0.05),曲美布汀治疗组与对照组之间无显著性差异;胃镜检查可见:曲美布汀治疗组与对照组的胆汁酸反流均得到有效控制,对两组空腹胃内容物检测的结果显示:两组中甘胆酸含量均显著下降(P<0.05),且胃酸PH值均回到正常范围内。结论:曲美布汀在微创胆道术后胆汁反流性胃炎中能有效减轻不良症状、保护胃黏膜,可作为为治疗胆汁反流性胃炎的一种新选择。

Objective：To study the effects of Trimebutine on bile reflux gastritis caused by minimally invasive biliary surgery.Methods：Seventy-nine cases diagnosed as bile reflux gastritis from January 2013 to January 2015 were randomly divided into two groups.The patients in observation group（Group I,n=38）were treated with pantoprazole sodium enteric coated 40 mg qd＋almagate suspension15ml（1.5g）tid ＋trimebutine maleate tablets 200 mg tid,and the patients in group II（n=41）were treated with pantoprazole sodium enteric coated 40 mg qd ＋ almagate suspension 15 ml（1.5g）tid ＋ domperidone tablets 10 mg tid.After 8weeks,epigastric pain,abdominal distention,belching,nausea and vomiting of all cases were recorded.Meanwhile,PH value and cholyglycine were measured.Results：After 8weeks of treatment,the clinical symptoms of the two groups were relieved.The bile acid reflux has been effectively alleviatedby gastroscopy.And the fasting gastric contents testing results showed that gastric acid pH value and cholylglycine were returned to normal range.Conclusion：Trimebutine were a new choice for the treatment of bile reflux gastritis due to its effectively alleviation of the adverse symptoms caused by bile reflux gastritis,and protect gastric mucosa.