莫沙必利联合雷贝拉唑钠肠溶片治疗老年性反流性食管炎疗效评价

Assessment of clinical efficacy of mosapride combined with rabeprazole sodium enteric-coated tablet in the treatment of senile reflux esophagitis

目的:探讨莫沙必利联合雷贝拉唑钠肠溶片治疗老年性反流性食管炎(RE)疗效。方法:选取我院收治的78例老年RE病人,随机分成对照组与观察组,每组39例。对照组予雷贝拉唑钠肠溶片每次20 mg,1次/天口服,观察组在此基础上再予莫沙必利每次5 mg,3次/天口服,均连续治疗8周。检测血浆胃肠激素[胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)]及血清细胞因子水平[白细胞介素(IL)-6、IL-8及肿瘤坏死因子(TNF)-α],测定24 h食管p H值,评定典型RE症状评分,比较临床疗效。结果:与治疗前比较,2组血浆GAS、MTL升高(P<0.01),VIP降低(P<0.01),血清IL-6、IL-8、TNF-α降低(P<0.01),p H值<4反流次数、反流持续时间≥5min反流次数、最长反流持续时间、p H值<4总时间、p H值<4时间百分比降低(P<0.01),烧心、反酸、胸骨后灼痛典型RE症状评分降低(P<0.01);与对照组比较,观察组GAS、MTL较高(P<0.01),VIP较低(P<0.01),IL-6、IL-8、TNF-α较低(P<0.01),p H值<4反流次数、反流持续时间≥5 min反流次数、最长反流持续时间、p H值<4总时间、p H值<4时间百分比较低(P<0.01),烧心、反酸、胸骨后灼痛典型RE症状评分较低(P<0.01),总有效率较高(P<0.05)。结论:莫沙必利联合雷贝拉唑钠肠溶片治疗老年RE效果满意,与调控MTL及IL-6、TNF-α等因子有关。

Objective： To investigate the clinical effects of mosapride combined with rabeprazole sodium enteric-coated tablet in the treatment of senile reflux esophagitis（ RE）. Methods： Seventy-eight elderly patients with RE were randomly divided into the control group and observation group（ 39 cases each group）. The control group was treated with 20 mg of rabeprazole sodium enteric-coated tablet each time,one tablet a day,and the observation group was treated with 5 mg of mosapride each time,3 times a day,based on the control group for 8 weeks. The serum levels of gastrointestinal hormones[gastrin（ GAS）,motilin（ MTL） and vasoactive intestinal peptide（ VIP） ] and cytokines,and 24 h p H value of esophagus were measured,and the score of typical RE symptom was evaluated. The clinical effect between two groups was compared. Results： Compared with before treatment,the serum levels of GAS and MTL in two groups increased（ P〈0. 01）,and the serum levels of VIP,IL-6,IL-8 and TNF-α in two groups decreased after treatment（ P〈0. 01）.Compared with before treatment,the number of reflux（ p H〈4）,reflux frequency（ reflux duration ≥5 min）,longest reflux duration time（ p H〈4）,total time（ p H〈4） and percentage of time（ p H〈4） in two groups decreased after treatment（ P〈0. 01）. Compared with before treatment,the scores of the typical RE symptoms（ heartburn,acid reflux and retrosternal burning pain） in two groups decreased after treatment（ P〈0. 01）. Compared with the control group,the levels of MTL and GAS in observation group were higher（ P〈0. 01）,the levels of VIP,IL-6,IL-8 and TNF-α in observation group were lower（ P〈0. 01）. Compared with the control group,the number of reflux（ p H〈4） and reflux frequency（ reflux duration ≥ 5 min）,longest reflux duration time（ p H〈4）,total time（ p H〈4） and percentage of time（ p H〈4） in observation group were lower（ P〈0. 01）. Compared with the control group,the scores of the typical RE symptoms（ heartburn,acid reflux,substernal burning pain） in observation group were lower（ P〈0. 01）,and the total effective rate in observation group was higher（ P〈0. 05）. Conclusions： The clinical effect of mosapride combined with rabeprazole sodium entericcoated tablet in the treatment of senile RE is good,which may be associated with the regulation of factrs such as MTL,IL-6,TNF-α and so on.