质子泵抑制剂联合促胃肠动力药对胃食管反流病患者唾液胃蛋白酶的影响

doi:10.3877/cma.j.issn.2095-8765.2021.03.006

中华胃食管反流病电子杂志 ›› 2021, Vol. 08 ›› Issue (03) : 140 -144. doi: 10.3877/cma.j.issn.2095-8765.2021.03.006

论著

质子泵抑制剂联合促胃肠动力药对胃食管反流病患者唾液胃蛋白酶的影响

伊里夏提·卡米力¹, 陈晓涛¹, 买买提·依斯热依力², 阿巴伯克力·乌斯曼², 克力木·阿不都热依木²^,^†(

)

^1. 830001　乌鲁木齐，新疆维吾尔自治区人民医院口腔科
^2. 830001　乌鲁木齐，新疆维吾尔自治区普外微创研究所

收稿日期:2021-03-12 出版日期:2021-08-15
通信作者: 克力木·阿不都热依木
基金资助:
新疆维吾尔自治区自然科学基金计划特培项目(2021D03010)

The effect of proton pump inhibitors combined with gastrointestinal motility drugs on salivary pepsin in patients with gastroesophageal reflux disease

Yilixiati·Kamili¹, Xiaotao Chen¹, Maimaiti·Yisireyili², Ababokeli·Wusiman², Kelimu·Abudureyimu²^,^†()

^1. Department of Stomatology, people's Hospital of Xinjiang Uygur Autunomous Region, Urumqi 830001, China
^2. Research Institute of Minimally Invasive Surgery, people's Hospital of Xinjiang Uygur Autunomous Region,Urumqi 830001, China

Received:2021-03-12 Published:2021-08-15
Corresponding author: Kelimu·Abudureyimu

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引用本文：

伊里夏提·卡米力, 陈晓涛, 买买提·依斯热依力, 阿巴伯克力·乌斯曼, 克力木·阿不都热依木. 质子泵抑制剂联合促胃肠动力药对胃食管反流病患者唾液胃蛋白酶的影响[J]. 中华胃食管反流病电子杂志, 2021, 08(03): 140-144.

Yilixiati·Kamili, Xiaotao Chen, Maimaiti·Yisireyili, Ababokeli·Wusiman, Kelimu·Abudureyimu. The effect of proton pump inhibitors combined with gastrointestinal motility drugs on salivary pepsin in patients with gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2021, 08(03): 140-144.

目的

分析质子泵抑制剂（PPI）联合促胃肠动力药物对胃食管反流病（GERD）患者唾液胃蛋白酶的影响PPI；

方法

质子泵抑制剂选取自2020年1月至2021年5月在新疆维吾尔自治区人民医院收治的93例GERD患者作为研究对象，采用随机数表法随机分为实观察组和对照组。其中观察组47例，给予质子泵抑制联合促胃肠动力药治疗；对照组46例，单纯给予治疗。分别记录2组患者治疗前和治疗后2个疗程GerdQ、RDQ、RSI、RSF量表评分以及晨起空腹、午餐后2 h、症状时的唾液样本进行胃蛋白酶检测值等指标。

结果

治疗前2组患者的性别（男性/女性）、年龄、体质量指数（BMI）、吸烟、饮酒、DeMeester评分等一般资料比较，差异无统计学意义（均P＞0.05）。与对照组相比，观察组治疗后GerdQ、RDQ、RSI、RSF等评分下降更明显，差异均有统计学意义（均P＜0.05）。与对照组相比，观察组治疗后晨起空腹、午餐后2 h、症状时的唾液胃蛋白酶浓度下降更明显，2组间差异均有统计学意义（均P＜0.05）。

结论

剂联合促胃肠动力药物能够更明显地降低GERD患者唾液胃蛋白酶浓度，同时更显著缓解GERD症状及降低反流评分，对病情控制效果更为显著。

关键词: 胃食管反流疾病, 唾液胃蛋白酶, 质子泵抑制剂, 促胃肠动力药

Objective

Analyze the effect of proton pump inhibitors combined with gastrointestinal motility drugs on salivary pepsin in patients with gastroesophageal reflux disease (GERD).

Methods

93 patients with GERD who were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to May 2021 were selected as the research objects, and were randomly divided into the study group and the control group using the digital table method. Among them, 47 cases in the experimental group were treated with proton pump inhibitors combined with gastrointestinal motility drugs; 46 cases in the control group were treated with proton pump inhibitors alone. The scores of GerdQ, RDQ, RSI, RSF scale before and after treatment were recorded for the two groups of patients, as well as the pepsin test values of saliva samples from fasting in the morning, 2 h after lunch, and symptoms.

Results

Before treatment, there was no significant difference in general data such as gender (male/female), age, BMI, smoking, drinking, DeMeester score, etc between the two groups of patients (all P＞0.05). Compared with the control group, the GerdQ, RDQ, RSI, RSF and other scores of the study group decreased more significantly after treatment, and the differences between the two groups were statistically significant (P＜0.05). Compared with the control group, the salivary pepsin concentration of the study group dropped more significantly in the morning on an empty stomach, 2 hours after lunch, and symptoms, and the difference between the two groups was statistically significant (statistics: experimental group n=47; control Group n=46; statistical values t=12.957, 14.573, 5.446, -17.219, -5.156; P＜0.05).

Conclusion

Proton pump inhibitors combined with gastrointestinal motility drugs can more significantly reduce the salivary pepsin concentration of patients with GERD, and at the same time more significantly alleviate the symptoms of GERD and reduce the reflux score, which has a more significant effect on disease control.

Key words: Gastroesophageal reflux disease, salivary pepsin, proton pump inhibitors, gastrointestinal motility drugs

表1 2组患者一般情况的比较

组别	例数	性别男性/女性	年龄（岁， $x ¯$ ±s）	BMI（kg/m²， $x ¯$ ±s）	吸烟是/否	饮酒是/否	DeMeester评分［M（Q₁，Q₂）］
观察组	47	28/19	41.3±11.0	27.7±3.6	25/22	20/27	34（20，47）
对照组	46	25/21	40.9±10.0	26.8±3.2	20/26	17/29	33（23，49）
χ²/t/Z值		0.259	0.185	1.317	0.878	0.304	-0.377
P值		0.611	0.854	0.191	0.349	0.581	0.707

表1 2组患者一般情况的比较

组别	例数	性别男性/女性	年龄（岁， $x ¯$ ±s）	BMI（kg/m²， $x ¯$ ±s）	吸烟是/否	饮酒是/否	DeMeester评分［M（Q₁，Q₂）］
观察组	47	28/19	41.3±11.0	27.7±3.6	25/22	20/27	34（20，47）
对照组	46	25/21	40.9±10.0	26.8±3.2	20/26	17/29	33（23，49）
χ²/t/Z值		0.259	0.185	1.317	0.878	0.304	-0.377
P值		0.611	0.854	0.191	0.349	0.581	0.707

表2 2组患者GerdQ、RDQ、RSI、RSF评分等指标比较（分，

x ˉ

±s）

组别	例数	GerdQ		RDQ		RSI		RSF
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	47	11.1±1.6	7.4±1.3	19.3±3.4	9.3±3.4	16.1±3.6	9.1±3.6	12.2±3.3	5.9±3.3
对照组	46	10.9±1.9	8.2±1.9	20.2±4.8	12.7±4.8	17.7±4.9	11.8±4.9	12.7±3.4	7.9±2.6
t值		0.648	-2.445	-1.139	-4.059	-1.840	-2.958	-0.677	-3.248
P值		0.519	0.016	0.258	＜0.001	0.069	0.004	0.500	0.002

表2 2组患者GerdQ、RDQ、RSI、RSF评分等指标比较（分，

x ˉ

±s）

组别	例数	GerdQ		RDQ		RSI		RSF
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	47	11.1±1.6	7.4±1.3	19.3±3.4	9.3±3.4	16.1±3.6	9.1±3.6	12.2±3.3	5.9±3.3
对照组	46	10.9±1.9	8.2±1.9	20.2±4.8	12.7±4.8	17.7±4.9	11.8±4.9	12.7±3.4	7.9±2.6
t值		0.648	-2.445	-1.139	-4.059	-1.840	-2.958	-0.677	-3.248
P值		0.519	0.016	0.258	＜0.001	0.069	0.004	0.500	0.002

表3 2组患者不同时间点的唾液胃蛋白酶浓度比较（ng/ml，

x ˉ

±s）

组别	例数	晨起空腹		午餐后2 h		症状时
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	47	117.9±21.7	70.0±9.6	112.3±25.7	74.5±9.2	127.1±14.5	71.2±12.0
对照组	46	119.2±19.0	79.1±6.5	111.8±27.1	85.3±12.8	128.6±14.6	76.3±12.6
t值		-0.302	-5.286	0.082	-4.643	-0.484	-2.003
P值		0.763	＜0.001	0.934	＜0.001	0.630	0.048

表3 2组患者不同时间点的唾液胃蛋白酶浓度比较（ng/ml，

x ˉ

±s）

组别	例数	晨起空腹		午餐后2 h		症状时
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	47	117.9±21.7	70.0±9.6	112.3±25.7	74.5±9.2	127.1±14.5	71.2±12.0
对照组	46	119.2±19.0	79.1±6.5	111.8±27.1	85.3±12.8	128.6±14.6	76.3±12.6
t值		-0.302	-5.286	0.082	-4.643	-0.484	-2.003
P值		0.763	＜0.001	0.934	＜0.001	0.630	0.048

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