艾普拉唑与雷贝拉唑治疗内镜黏膜下剥离术后人工溃疡愈合的效果对比

Comparison of the effects of ilaprazole and rabeprazole in the treatment of artificial ulcer after endoscopic submucosal dissection

目的评价对比艾普拉唑与雷贝拉唑治疗内镜黏膜下剥离术后人工溃疡的效果。方法选取行内镜黏膜下剥离术的患者共140例,随机分为艾普拉唑组和雷贝拉唑组,每组70例。艾普拉唑组每天使用艾普拉唑20 mg,雷贝拉唑组每天使用雷贝拉唑20 mg,两组均共使用8周。对比两组患者术后4周和8周的溃疡面积和愈合质量,比较两组患者术前、术后4周和8周的消化道症状以及延迟出血的发生比例。结果两组患者的初始溃疡面积对比差异无统计学意义(P>0.05),而术后4周和8周艾普拉唑组的溃疡面积均显著小于雷贝拉唑组,差异有统计学意义(P<0.05)。术后8周艾普拉唑组扁平愈合的比例显著高于雷贝拉唑组,差异有统计学意义(χ^(2)=5.011,P=0.025)。两组患者术前的GSRS评分对比差异无统计学意义(P>0.05),术后4周和8周艾普拉唑组的GSRS评分显著低于雷贝拉唑组,差异有统计学意义(P<0.05)。结论内镜黏膜下剥离术后人工溃疡的患者,采用艾普拉唑其对溃疡愈合的效果以及胃肠道症状的控制优于雷贝拉唑。

Objective To evaluate the effect of ilaprazole and rabeprazole in the treatment of artificial ulcer after endoscopic submucosal dissection(ESD). Methods A total of 140 patients received endoscopic submucosal dissection were randomly divided into the ilaprazole group and the rabeprazole group(n=70);in which iprazol 20 mg daily and rabeprazole 20 mg daily, respectively, were given for 8 weeks. The ulcer area and healing quality at 4 weeks and 8 weeks were compared between the two groups. The gastrointestinal symptoms and delayed bleeding before operation, and at 4 weeks and 8 weeks were compared between the two groups. Results There was no significant difference in initial ulcer area between the two groups(P>0.05). The ulcer areas at 4 weeks and 8 weeks in ilaprazole group were significantly smaller than those of the rabeprazole group(P<0.05). The proportion of flat healing in the ilaprazole group was significantly higher than that in the rabeprazole group 8 weeks after surgery(χ^(2)=5.011, P=0.025). There was no significant difference in the preoperative GSRS scores between the two groups(P>0.05). The GSRS scores at 4 weeks and 8 weeks in ilaprazole group were significantly lower than those of the rabeprazole group(P<0.05). Conclusion In patients with artificial ulcer after ESD, the effect of ilaprazole on ulcer healing and gastrointestinal symptoms is better than rabeprazole.