莫沙必利联合质子泵抑制剂治疗老年胃食管反流病患者疗效及其对肠道菌群和胃肠激素水平的影响

Curative effects of mosapride combined with proton pump inhibitor and its influences on intestinal floras and gastrointestinal hormones in elderly patients with gastroesophageal reflux disease

目的观察莫沙必利联合质子泵抑制剂(PPI)治疗老年胃食管反流病(GERD)患者的疗效及其对肠道菌群和胃肠激素水平的影响。方法选择2021年1月-2023年3月遂宁市中心医院收治的82例GERD患者,按随机数字表法分为试验组(n=41)和对照组(n=41)。对照组予以PPI治疗,试验组予以莫沙必利联合PPI治疗,2组疗程均为8周。比较2组疗效、反流症状、肠道菌群、胃肠激素水平和治疗不良反应。结果治疗后,试验组的总有效率高于对照组(P<0.05);2组反流性疾病问卷(RDQ)评分、DeMeester评分、24 h反流最长时间、酸反流、弱酸反流、弱碱反流次数及pH<4时间占检测时间的百分比、大肠埃希菌、葡萄球菌数量、生长抑素(SS)、舒血管肠肽(VIP)均低/少于同组治疗前,且试验组低/少对照组,差异具有统计学意义(P<0.05);2组双歧杆菌数量、乳酸杆菌数量、胃泌素(GAS)水平、胃动素(MTL)水平大/高于同组治疗前,且试验组大/高于对照组(P<0.05);2组治疗不良反应发生率差异无统计学意义(P>0.05)。结论莫沙必利联合PPI治疗老年GERD患者,疗效显著,可有效地缓解患者的相关症状体征,维持肠道菌群的平衡,改善胃肠道功能,具有一定的临床应用价值。

Objective To explore the curative effects of mosapride combined with proton pump inhibitor(PPI)and its influences on intestinal floras and gastrointestinal hormones in elderly patients with gastroesophageal reflux disease(GERD).Methods 82 GERD patients admitted to Central Hospital of Suining City from January 2021 to March 2023 were selected and divided into experimental group(n=41)and control group(n=41)according to random number table method.The control group was treated with PPI,while the experimental group was treated with mosapride combined with PPI.The treatment course of both groups was 8 weeks.The efficacy,reflux symptoms,intestinal flora,gastrointestinal hormone level and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of the experimental group was higher than that of the control group(P<0.05).The scores of Reflux Diagnostic Questionnaire(RDQ)and DeMeester,the longest 24-hour reflux time,the frequency of acid reflux,weak acid reflux and weak base reflux,percentage of pH<4 time in detection time,as well as the number of Escherichia Coli and Staphylococcus aureus,and the levels of somatostatin(SS)and vasoactive intestinal peptide(VIP)of both groups were lower/less after treatment than those of the same group before treatment,and the experimental group was lower/less than the control group,with statistically significant differences(P<0.05).The number of Bifidobacterium and Lactobacillus,and the levels of gastrin(GAS)and motilin(MTL)of both groups after treatment were larger/higher than those of the same group before treatment,and the experimental group was larger/higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of mosapride and PPI in the treatment of elderly GERD patients has a significant therapeutic effect,which can effectively alleviate the relevant symptoms and signs of patients,maintain the balance of intestinal flora,improve gastrointestinal function,and has certain clinical application value.