莫沙必利联合奥美拉唑镁对反流性食管炎患者胃分泌功能、血清Ghrelin、Leptin水平的影响

Effect of mosapride combined with omeprazole magnesium on gastric secretion function,serum Ghrelin and Leptin levels in patients with reflux esophagitis

目的探讨莫沙必利联合奥美拉唑镁对反流性食管炎患者胃分泌功能、血清人生长素释放多肽(Ghrelin)、瘦素(Leptin)水平的影响作用。方法回顾性选取2022年2月~2023年2月泸县人民医院诊治的180例反流性食管炎患者,根据治疗方案分为奥美拉唑镁组(n=86)和联合用药组(n=94)。奥美拉唑镁组使用奥美拉唑镁肠溶片进行治疗,联合用药组在奥美拉唑镁组的基础上联合枸橼酸莫沙必利片进行治疗。比较两组患者的临床疗效;比较两组患者胃分泌功能[胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃动素(MOT)、血管活性肠肽(VIP)]变化情况;比较两组患者血清Ghrelin和Leptin水平;比较两组患者治疗期间不良反应情况。结果联合用药组的总有效率(94.68%)显著高于奥美拉唑镁组的总有效率(81.40%),差异有统计学意义(χ^(2)=7.692,P<0.05)。治疗后,两组患者PGⅡ、VIP、Leptin水平显著低于治疗前,且联合用药组PGⅡ、VIP、Leptin水平明显低于奥美拉唑镁组[(14.85±1.73)μg L vs.(21.51±2.11)μg L、(13.41±1.27)pg ml vs.(20.45±1.15)pg ml、(8.11±1.13)pg ml vs.(16.52±2.73)pg ml],差异有统计学意义(t=23.236、38.857、27.416,P<0.05)。治疗后,两组患者GAS、PGⅠ、MOT、Ghrelin水平明显高于治疗前,且联合用药组GAS、PGⅠ、MOT、Ghrelin水平明显高于奥美拉唑镁组[(96.85±5.81)pg ml vs.(78.76±4.87)pg ml、(132.71±11.26)μg L vs.(120.42±10.84)μg L、(280.24±21.67)pg ml vs.(200.56±17.62)pg ml、(26.46±3.41)pg ml vs.(19.64±3.85)pg ml],差异有统计学意义(t=22.527、7.446、26.915、12.602,P<0.05)。治疗期间两组不良反应差异无统计学意义(χ^(2)=1.738,P>0.05)。结论莫沙必利联合奥美拉唑镁治疗反流性食管炎患者临床效果显著,安全性比较好,可以有效改善胃分泌功能,调节血清Ghrelin、Leptin水平平衡,进而改善反流现象,具有良好的临床应用价值。

Objective To investigate the effect of mosapride combined with omeprazole magnesium on gastric secretion function,serum Ghrelin and Leptin levels in patients with reflux esophagitis.Methods A retrospective selection of 180 patients with reflux esophagitis diagnosed and treated from February 2022 to February 2023 were selected as the study subjects.According to the treatment plan,they were divided into omeprazole magnesium group(n=86)and combination group(n=94).The omeprazole magnesium group was treated with omeprazole magnesium enteric-coated tablets,and the combined medication group was treated with mosapride citrate tablets on the basis of the omeprazole magnesium group.The clinical efficacy,gastric secretion function[gastrin(GAS),pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),motilin(MOT),vasoactive intestinal peptide(VIP)],serum Ghrelin and Leptin levels,and adverse reactions were analyzed and compared between the two groups.Results The total effective rate of the combined medication group(94.68%)was significantly higher than that of the omeprazole magnesium group(81.40%)(χ^(2)=7.692,P<0.05).The levels of PGⅡ,VIP and Leptin in the two groups after treatment were significantly lower than those before treatment,and those in the combination group were significantly lower than those in the omeprazole magnesium group(t=23.236,38.857,27.416,P<0.05).The levels of GAS,PGⅠ,MOT and Ghrelin in the two groups after treatment were significantly higher than those before treatment,and the levels in the combination group were significantly higher than those in the omeprazole magnesium group(t=22.527,7.446,26.915,12.602,P<0.05).There was no significant difference in the probability of adverse reactions between the two groups during the treatment(χ^(2)=1.738,P>0.05).Conclusion Mosapride combined with omeprazole magnesium in the treatment of patients with reflux esophagitis has a significant clinical effect and good safety.It can effectively improve the gastric secretion function,regulate the balance of serum Ghrelin and Leptin levels,and then improve the reflux phenomenon,which has good clinical application value.