莫沙必利与多潘立酮治疗功能性消化不良的效果及对胃动力指标、胃肠激素的影响

Efficacy of mosapride versus domperidone in the treatment of functional dyspepsia and its effects on gastric motility indexes and gastrointestinal hormone levels

目的分析莫沙必利、多潘立酮分别在治疗功能性消化不良(FD)中的效果以及对胃动力指标、胃肠激素的影响。方法选择湖州市菱湖人民医院2019年5月至2021年5月收治的FD患者94例,采用随机数字表法将其分为研究组与对照组各47例,对照组给予多潘立酮治疗,研究组给予莫沙必利治疗,对比两组患者疗效。结果研究组有效率为95.74%,高于对照组的80.85%,差异有统计学意义(χ^(2)=5.04,P=0.025);用药后,研究组胃动力指标中胃动素(MTL)、血浆瘦素(LEP)以及促肾上腺皮质激素释放激素(CRH)分别为(184.22±25.36)μg/mL、(18.57±2.44)μg/L、(7.21±1.14)pg/mL,均优于对照组的(111.25±21.00)μg/mL、(15.41±2.28)μg/L以及(9.02±1.32)pg/mL(t=15.19、6.48、16.23,P<0.001、<0.001、<0.001);用药后,研究组胃肠激素相关指标中胆囊收缩素(CCK)、生长抑素(SS)、血管活性肠肽(VIP)、促胃泌素(GAS)分别为(45.36±5.12)ng/L、(5.48±1.25)ng/L、(86.35±12.11)pg/mL以及(105.24±12.05)ng/L,均优于对照组的(50.21±6.18)ng/L、(7.01±0.98)ng/L、(98.75±14.18)pg/mL以及(97.35±11.48)ng/L(t=4.14、6.60、4.55、3.25,P<0.001、<0.001、<0.001、0.002);研究组复发率为2.13%,低于对照组的27.66%;不良反应发生率为14.89%,低于对照组的34.04%(χ^(2)=4.66、10.80,P=0.031、0.001)。结论采用莫沙必利治疗FD的效果更佳,对改善患者胃动力指标以及胃肠激素水平的效果显著,且复发率相对较低,可在临床推广。

Objective To investigate the efficacy of mosapride versus domperidone in the treatment of functional dyspepsia and its effects on gastric motility indexes and gastrointestinal hormone levels.Methods Ninety-four patients with functional dyspepsia who received treatment in Huzhou Linghu People's Hospital between May 2019 and May 2021 were included in this study.They were randomly assigned to undergo treatment with either domperidone(control group,n=47)or mosapride(study group,n=47).Efficacy was compared between the two groups.Results Total response rate in the study group was significantly higher than that in the control group(χ^(2)=5.04,P=0.025).After medication,motilin,plasma leptin and corticotropin-releasing hormone in the study group were(184.22±25.36)μg/mL,(18.57±2.44)μg/L,(7.21±1.14)pg/mL,respectively,which were superior to those in the control group[(111.25±21.00)μg/mL,(15.41±2.28)μg/L,(9.02±1.32)μg/mL,t=15.19,6.48,16.23,P<0.001,<0.001,<0.001].After medication,cholecystokinin,somatostatin,vasoactive intestinal peptide and gastrin levels in the study group were(45.36±5.12)ng/L,(5.48±1.25)ng/L,(86.35±12.11)pg/mL,and(105.24±12.05)ng/L,respectively,which were significantly superior to those in the control group[(50.21±6.18)ng/L,(7.01±0.98)ng/L,(98.75±14.18)pg/mL and(97.35±11.48)ng/L,t=4.14,6.60,4.55,3.25,P<0.001,<0.001,<0.001,<0.002].The recurrence rate in the study group was significantly lower than that in the control group(2.13%vs.27.66%,χ^(2)=4.66,P=0.031).The incidence of adverse reactions in the study group was significantly lower than that in the control group(14.89%vs.34.04%,χ^(2)=10.80;P=0.001).Conclusion Mosapride has a better therapeutic effect on functional dyspepsia,exhibits a greater effect on improving gastric motility indexes and gastrointestinal hormone levels,and leads to a lower incidence of recurred functional dyspepsia than domperidone.Therefore,mosapride for treatment of functional dyspepsia deserves clinical promotion.