Thong-Ngam Duangporn, Chayanupatkul Maneerat, Klaikeaw Naruemon, Rerknimitr Rungsun, Mahachai Varocha
Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Sep;92(9):1207-12.
Rebamipide, a gastro-protective drug, acts on stimulation of prostaglandin and mucus glycoprotein synthesis, inhibition of reactive oxygen species, inflammatory cytokines, and neutrophils activation.
To investigate the effect of rebamipide (mucosta) on healing of gastric ulcer caused by various etiologies.
Thirty patients with gastric ulcer underwent gastric antral and body biopsies for histopathology. Group classifications depended on H. pylori status using CLO test, histology or urea breath test and history ofNSAIDs taking. All patients received rebamipide 100 mg, three times a day, for 8 weeks. The symptoms and adverse effects were assessed in 4 weeks and 8 weeks after prescription. At the end of the present study, an endoscopy was repeated to evaluate ulcer healing and biopsy for gastric inflammation grading.
According to the ulcer cause, there were seven patients with H. pylori+ NSAIDs+, nine patients with H. pylori + NSAIDs-, three patients with H. pylori - NSAIDs +, and 11 patients with H. pylori - NSAIDs-. The ulcers were completely healed in most patients with a history of NSAIDs use. There was a significant improvement of symptom scores from baseline in all groups (5.9 vs. 0.6, p < 0.001). The improvement of gastric inflammation scores were favorable in NSAIDs users (2.38 vs. 1.75, p = 0.011). All patients were satisfied as there were few adverse effects.
Rebamipide is effective and well tolerated for treatment of gastric ulcers especially those caused by NSAIDs, as it promotes the improvement of gastric inflammation scores, clinical symptoms, and ulcer healing.
瑞巴派特是一种胃保护药物，作用于刺激前列腺素和黏液糖蛋白合成，抑制活性氧、炎性细胞因子及中性粒细胞活化。
研究瑞巴派特（膜固思达）对各种病因所致胃溃疡愈合的影响。
30例胃溃疡患者接受胃窦和胃体活检以进行组织病理学检查。根据采用CLO试验、组织学检查或尿素呼气试验的幽门螺杆菌感染状况及非甾体抗炎药服用史进行分组。所有患者均接受瑞巴派特100mg，每日3次，共8周。在服药4周和8周时评估症状及不良反应。在本研究结束时，再次进行内镜检查以评估溃疡愈合情况，并进行胃炎症分级活检。
根据溃疡病因，有7例幽门螺杆菌阳性+非甾体抗炎药使用者，9例幽门螺杆菌阳性+非甾体抗炎药非使用者，3例幽门螺杆菌阴性+非甾体抗炎药使用者，以及11例幽门螺杆菌阴性+非甾体抗炎药非使用者。大多数有非甾体抗炎药使用史的患者溃疡完全愈合。所有组的症状评分较基线均有显著改善（5.9对0.6，p<0.001）。非甾体抗炎药使用者的胃炎症评分改善良好（2.38对1.75，p=0.011）。由于不良反应少，所有患者均满意。
瑞巴派特治疗胃溃疡尤其是由非甾体抗炎药引起的胃溃疡有效且耐受性良好，因为它能促进胃炎症评分、临床症状及溃疡愈合的改善。
