Asakuma Yutaka, Kudo Masatoshi, Matsui Shigenaga, Okada Mumon, Kawasaki Masanori, Umehara Yasushi, Ichikawa Tsutomu, Kitai Satoshi
Department of Gastroenterology and Hepatology, Kinki University, School of Medicine, 377-2 Ohno-Higashi, Osaka-sayama 589-8511, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1270-3.
BACKGROUND/AIMS: Ecabet sodium (ES) is a widely employed mucoprotective agent, for the treatment of gastric ulcers. The present paper prospectively evaluate the additive benefits of using ES in combination with the rabeprazole proton pump inhibitor (PPI) for the treatment of gastric ulcers after endoscopic submucosal dissection (ESD).
A total of 56 patients who had undergone ESD for early gastric cancers were randomly assigned to receive either PPI with ES (P/ES group, n=28) or PPI alone (PPI group, n=28) for 8 weeks. At 4 and 8 weeks after ESD, the healing rate and the diminution rate of the ulcers were compared between two groups by endoscopy.
One patient in the PPI group developed a hemorrhage as a result of an ESD-induced ulcer. At 4 weeks, the healing rates were significantly higher in the P/ES group (40.7%) compared with the PPI group (11.5%), (p = 0.0013). This tendency was observed also at 8 weeks (p = 0.0446). In addition, at 4 weeks, the diminution rates of the ESD-induced ulcers were significantly higher in the P/ES group (95.8%) than in the PPI group (84.9%), (p=0.0033).
ES in combination with PPI facilitates increased healing of ESD-induced ulcers, and can also improve the quality of ulcer healing.
背景/目的：伊索佳硫酸氨基葡萄糖（ES）是一种广泛应用的黏膜保护剂，用于治疗胃溃疡。本文前瞻性评估了ES与雷贝拉唑质子泵抑制剂（PPI）联合使用对内镜黏膜下剥离术（ESD）后胃溃疡的附加益处。
共有56例因早期胃癌接受ESD的患者被随机分为两组，分别接受PPI联合ES治疗（P/ES组，n = 28）或单独接受PPI治疗（PPI组，n = 28），为期8周。在ESD术后4周和8周，通过内镜比较两组溃疡的愈合率和缩小率。
PPI组有1例患者因ESD引起的溃疡发生出血。4周时，P/ES组的愈合率（40.7%）显著高于PPI组（11.5%），（p = 0.0013）。8周时也观察到这种趋势（p = 0.0446）。此外，4周时，P/ES组ESD引起的溃疡缩小率（95.8%）显著高于PPI组（84.9%），（p = 0.0033）。
ES联合PPI可促进ESD引起的溃疡愈合增加，并可改善溃疡愈合质量。
