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

摘要

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 hormones[gastrin(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.%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.