莫沙必利联合雷贝拉唑钠肠溶片治疗老年性反流性食管炎疗效评价

谢妲

doi:10.13898/j.cnki.issn.1000-2200.2017.06.014

莫沙必利联合雷贝拉唑钠肠溶片治疗老年性反流性食管炎疗效评价

谢妲

Assessment of clinical efficacy of mosapride combined with rabeprazole sodium enteric-coated tablet in the treatment of senile reflux esophagitis

XIE Da

摘要

摘要: 目的：探讨莫沙必利联合雷贝拉唑钠肠溶片治疗老年性反流性食管炎（RE）疗效。方法：选取我院收治的78例老年RE病人，随机分成对照组与观察组，每组39例。对照组予雷贝拉唑钠肠溶片每次20 mg，1次/天口服，观察组在此基础上再予莫沙必利每次5 mg，3次/天口服，均连续治疗8周。检测血浆胃肠激素胃泌素（GAS）、胃动素（MTL）、血管活性肠肽（VIP）及血清细胞因子水平白细胞介素（IL）-6、IL-8及肿瘤坏死因子（TNF）-α，测定24 h食管pH值，评定典型RE症状评分，比较临床疗效。结果：与治疗前比较，2组血浆GAS、MTL升高（P<0.01），VIP降低（P<0.01），血清IL-6、IL-8、TNF-α降低（P<0.01），pH值<4反流次数、反流持续时间≥5min反流次数、最长反流持续时间、pH值<4总时间、pH值<4时间百分比降低（P<0.01），烧心、反酸、胸骨后灼痛典型RE症状评分降低（P<0.01）；与对照组比较，观察组GAS、MTL较高（P<0.01），VIP较低（P<0.01），IL-6、IL-8、TNF-α较低（P<0.01），pH值<4反流次数、反流持续时间≥5 min反流次数、最长反流持续时间、pH值<4总时间、pH值<4时间百分比较低（P<0.01），烧心、反酸、胸骨后灼痛典型RE症状评分较低（P<0.01），总有效率较高（P<0.05）。结论：莫沙必利联合雷贝拉唑钠肠溶片治疗老年RE效果满意，与调控MTL及IL-6、TNF-α等因子有关。

Abstract: Objective: To investigate the clinical effects of mosapride combined with rabeprazole sodium enteric-coated tablet in the treatment of senile reflux esophagitis(RE). Methods: Seventy-eight elderly patients with RE were randomly divided into the control group and observation group(39 cases each group).The control group was treated with 20 mg of rabeprazole sodium enteric-coated tablet each time,one tablet a day,and the observation group was treated with 5 mg of mosapride each time,3 times a day,based on the control group for 8 weeks.The serum levels of gastrointestinal hormonesgastrin(GAS),motilin(MTL) and vasoactive intestinal peptide(VIP) and cytokines,and 24 h pH value of esophagus were measured,and the score of typical RE symptom was evaluated.The clinical effect between two groups was compared. Results: Compared with before treatment,the serum levels of GAS and MTL in two groups increased (P<0.01),and the serum levels of VIP,IL-6,IL-8 and TNF-α in two groups decreased after treatment(P<0.01).Compared with before treatment,the number of reflux(pH<4),reflux frequency(reflux duration ≥ 5 min),longest reflux duration time(pH<4),total time(pH<4)and percentage of time(pH<4) in two groups decreased after treatment(P<0.01).Compared with before treatment,the scores of the typical RE symptoms(heartburn,acid reflux and retrosternal burning pain) in two groups decreased after treatment(P<0.01).Compared with the control group,the levels of MTL and GAS in observation group were higher(P<0.01),the levels of VIP,IL-6,IL-8 and TNF-α in observation group were lower(P<0.01).Compared with the control group,the number of reflux(pH<4) and reflux frequency(reflux duration ≥ 5 min),longest reflux duration time(pH<4),total time(pH<4)and percentage of time(pH<4) in observation group were lower(P<0.01).Compared with the control group,the scores of the typical RE symptoms(heartburn,acid reflux,substernal burning pain) in observation group were lower(P<0.01),and the total effective rate in observation group was higher(P<0.05). Conclusions: The clinical effect of mosapride combined with rabeprazole sodium enteric-coated tablet in the treatment of senile RE is good,which may be associated with the regulation of factrs such as MTL,IL-6, TNF-α and so on.

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