瑞巴派特联合艾司奥美拉唑治疗糜烂性胃炎的疗效及对黏膜屏障的影响

Efficacy of Rebamipide Combined with Esomeprazole in the Treatment of Erosive Gastritis and Its Effect on the Gastric Mucosal Barrier

摘要

目的 探讨瑞巴派特联合艾司奥美拉唑治疗糜烂性胃炎的疗效及对黏膜屏障的影响。方法 选择 2024 年 2 月至 2025 年 2 月宁国市人民医院收治的 96 例糜烂性胃炎患者，按照随机密封信封法分为观察组、对照组，各 48 例。对照组在常规治疗基础上予艾司奥美拉唑治疗，观察组在对照组基础上联合瑞巴派特片治疗，2 组均持续治疗 4 周。比较 2 组治疗 4 周后的临床疗效；比较治疗前、治疗 2 周及 4 周后的胃黏膜屏障功能指标[胃蛋白酶原（pepsinogen，PG）Ⅰ、PGⅡ、PGⅠ/PGⅡ比值]、胃肠激素[胃泌素（gastrin，GAS）、胃动素（motilin，MTL）]、胃黏膜形态学评分（黏膜厚度、炎性细胞浸润程度）；比较治疗前、治疗 4 周后及随访 1 个月时的胃肠道生活质量指数（Gastrointestinal Quality of Life Index，GIQLI）量表评分，并记录治疗期间不良反应发生情况。结果 治疗 4 周后，与对照组比较，观察组总有效率更高（P< 0.05）。治疗 2 周、4 周后，观察组的 PGⅠ、PGⅠ/PGⅡ比值、MTL 高于对照组，GAS、黏膜厚度评分、炎性细胞浸润程度评分低于对照组（ P< 0.05）。治疗 4 周后、随访 1 个月时，观察组的 GIQLI 量表评分更高（ P< 0.05）。2 组不良反应比较，差异无统计学意义（ P> 0.05）。结论 瑞巴派特联合艾司奥美拉唑治疗糜烂性胃炎疗效显著，可有效改善黏膜屏障功能、胃肠激素水平及胃黏膜形态学指标，且安全性好，值得临床推广。

Abstract

Objective To explore the efficacy of rebamipide combined with esomeprazole in the treatment of erosive gastritis and its influence on the mucosal barrier. Methods 96 cases of erosive gastritis admitted to Ningguo People's Hospital from February 2024 to February 2025 were selected, and randomly divided into the observation group and the control group, with 48 cases in each group. The control group received esomeprazole on the basis of conventional treatment, while the observation group was additionally treated with rebamipide tablets on the basis of the control group regimen. All patients were treated continuously for 4 weeks. Clinical efficacy at 4 weeks after treatment was compared between the two groups. Gastric mucosal barrier function indicators [pepsinogen (PG) Ⅰ, PG Ⅱ, PG Ⅰ/PG Ⅱ ratio], gastrointestinal hormones [gastrin (GAS), motilin (MTL)], and gastric mucosal morphology scores (mucosal thickness, inflammatory cell infiltration) were compared at baseline, 2 and 4 weeks after treatment. Gastrointestinal Quality of Life Index (GIQLI) scores were also compared at baseline, 4 weeks after treatment and the 1-month follow-up. Adverse reactions during treatment were recorded.Results After 4 weeks of treatment, the observation group had a significantly higher overall response rate compared with the control group (P< 0.05). At 2 and 4 weeks post-treatment, the observation group presented higher levels of PG I, PG I/PG II ratio and MTL, as well as lower GAS level, mucosal thickness score and inflammatory cell infiltration score ( P< 0.05). Significantly higher GIQLI scores were also observed in the observation group at 4 weeks after treatment and the 1-month follow-up ( P< 0.05). No significant difference in adverse reactions was found between the two groups ( P> 0.05). Conclusion Rebamipide combined with esomeprazole achieves remarkable efficacy in the treatment of erosive gastritis. It can effectively improve gastric mucosal barrier function, gastrointestinal hormone levels and gastric mucosal morphology, with a favorable safety profile. This regimen is worthy of clinical application.

关键词

糜烂性胃炎 / 瑞巴派特 / 艾司奥美拉唑 / 黏膜屏障功能 / 疗效

Key words

erosive gastritis / rebamipide / esomeprazole / mucosal barrier function / therapeutic effect

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基金资助

医学人工智能联合基金资助项目(MAI2023Q029)