奥美拉唑钠联合西咪替丁治疗老年消化性溃疡疗效及对患者血清中Ghrelin和Leptin水平的影响

Efficacy of Omeprazole Sodium Combined with Cimetidine in the Treatment of Elderly Peptic Ulcers and Its Effects on Levels of Serum Ghrelin and Leptin

目的:探究奥美拉唑钠联合西咪替丁治疗老年消化性溃疡疗效及对患者血清中生长激素释放多肽(Ghrelin)和瘦素(Leptin)水平的影响。方法:对我院2018年4月至2020年1月期间收治的老年消化性溃疡患者进行编号,采用计算机随机抽取146例,以简单随机分组分为联合组和对照组各73例,对照组给予西咪替丁钠治疗,联合组在对照组基础上加用奥美拉唑治疗。比较两组治疗3周后疗效、症状缓解时间、治疗前后胃肠功能[瘦素(Leptin)、促胃素(gastrin)、生长激素释放多肽(Ghrelin)、胃动素(motilin)]、血清生化指标[血清白介素6(IL-6)、超敏C-反应蛋白(hs-CRP)、超氧化物歧化酶(SOD)、血管内皮生长因子(VEGF)]水平、不良反应及复发率。结果:治疗后,联合组临床疗效显著优于对照组(P<0.05);联合组便血时间、呕血时间、黑便消失时间均低于对照组,Hp根除率高于对照组,组间对比差异有统计学意义(P<0.05),两组住院时间对比差异无统计学意义(P>0.05)。治疗3周后,两组血清Leptin、gastrin水平显著降低(P<0.05),Ghrelin、motilin水平显著升高(P<0.05),血清IL-6、hs-CRP水平显著降低(P<0.05),SOD、VEGF水平显著升高(P<0.05),且治疗后上述指标组间对比差异显著(P<0.05);治疗期间,联合组不良反应发生率为5.48%,对照组为8.22%,两组不良反应发生率无对比显著差异(P>0.05);治疗后随访6个月内,联合组出现2例复发现象,发生率为2.74%,对照组出现8例复发现象,发生率为10.96%,两组对比差异显著(P<0.05)。结论:奥美拉唑钠联合西咪替丁可显著提高老年消化性溃疡的临床疗效,降低血清炎症,改善胃功能,不良反应少且复发率较低。

Objective:To explore the efficacy of omeprazole sodium combined with cimetidine in the treatment of elderly peptic ulcers and its effects on levels of serum growth hormone releasing polypeptide(Ghrelin)and Leptin of patients.Methods:The elderly patients with peptic ulcer admitted to our hospital from April 2018 to January 2020 were numbered,and 146 cases were randomly selected by computer and divided into the combined group and the control group,73 cases in each,according to the random number table method.Control group was treated with cimetidine sodium,and combined group was additionally administered omeprazole on the basis of control group.The efficacy after 3 weeks of treatment,symptom relief time,levels of gastrointestinal function[Leptin,gastrin,growth hormone releasing polypeptide(Ghrelin),motilin]and serum biochemical indicators[serum interleukin 6(IL-6),high-sensitivity C-reaction protein(hs-CRP),superoxide dismutase(SOD),vascular endothelial growth factor(VEGF)]before and after treatment,adverse reactions and recurrence rates were compared between the two groups.Results:After treatment,the clinical efficacy of combined group was significantly better than that of control group(P<0.05).The hematochezia time,hematemesis time and melena disappearance time of combined group were shorter than those of control group while the Hp eradication rate was higher than that in control group(P<0.05),and there was no statistically significant difference in hospital stay between the two groups(P>0.05).After 3 weeks treatment,the levels of serum Leptin and gastrin in the two groups were significantly reduced(P<0.05)while the levels of Ghrelin and motilin were significantly increased(P<0.05),and the levels of serum IL-6 and hs-CRP were significantly decreased(P<0.05)while the levels of SOD and VEGF were significantly increased(P<0.05),and there were significant differences in the above indexes between the groups after treatment(P<0.05).During treatment,the incidence rate of adverse reactions was 5.48%in combined group and was 8.22%in control group,and there was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Within 6 months of follow-up after treatment,there were 2 cases of recurrence in combined group,the incidence rate was 2.74%,and there were 8 cases in control group,the incidence rate was 10.96%(P<0.05).Conclusion:Omeprazole sodium combined with cimetidine can significantly improve the clinical efficacy of elderly peptic ulcers,reduce serum inflammation and improve gastric function,with fewer adverse reactions and a lower recurrence rate.