Department of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Gastroenterol Hepatol. 2019 Aug;34(8):1344-1350. doi: 10.1111/jgh.14614. Epub 2019 Feb 17.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a major cause of gastric mucosal lesions. In China, teprenone is frequently prescribed as a mucoprotective agent, but the literature regarding their efficacy is limited. Our purpose was to address the effects of teprenone on long-term NSAID-associated gastric mucosal lesions.
This study examined 369 patients taking NSAIDs for at least 12 weeks. Patients without gastroduodenal ulcer and without Helicobacter pylori infection on endoscopy at baseline were randomized to receive either NSAID plus teprenone (150 mg/day) or NSAID only for 12 weeks. Lanza scores were examined using endoscopy before and after treatment, and dyspeptic symptom scores are also analyzed.
A total of 158 patients were randomized to the teprenone group (n = 74) or the control group (n = 84) for 12 weeks. Seventy-one of patients in the teprenone group and 79 of patients in the control group were analyzed finally. After treatment, the Lanza scores and dyspeptic symptom scores decreased significantly in the teprenone group while increased in the control group (P < 0.05). The changes of Lanza scores and dyspeptic symptom scores were higher in the teprenone group than in the control group (P < 0.05). For subgroup analysis, the change in Lanza scores and dyspeptic symptom scores improved significantly in the teprenone group receiving long-term low-dose aspirin treatment, as well as in the teprenone group receiving other NSAIDs treatment (P < 0.05).
Teprenone may be an effective treatment choice of gastric mucosal injuries and dyspepsia symptoms in patients who used NSAIDs chronically without H. pylori infection or history of gastroduodenal ulcer.
非甾体抗炎药(NSAIDs)是胃黏膜损伤的主要原因。在中国,替普瑞酮常被用作黏膜保护剂,但相关疗效的文献有限。本研究旨在探讨替普瑞酮对长期 NSAIDs 相关胃黏膜损伤的影响。
本研究纳入了 369 例至少服用 NSAIDs 12 周的患者。基线内镜检查无胃十二指肠溃疡且无幽门螺杆菌感染的患者,被随机分为 NSAIDs 联合替普瑞酮(150mg/天)组或仅 NSAIDs 组,治疗 12 周。治疗前后采用内镜检查 Lanza 评分,并分析消化不良症状评分。
共 158 例患者被随机分为替普瑞酮组(n=74)或对照组(n=84),治疗 12 周。最终替普瑞酮组 71 例和对照组 79 例患者纳入分析。治疗后,替普瑞酮组 Lanza 评分和消化不良症状评分较治疗前显著降低,而对照组则显著升高(P<0.05)。替普瑞酮组的 Lanza 评分和消化不良症状评分变化明显高于对照组(P<0.05)。亚组分析显示,长期低剂量阿司匹林治疗和其他 NSAIDs 治疗的替普瑞酮组,Lanza 评分和消化不良症状评分的变化均显著改善(P<0.05)。
对于无幽门螺杆菌感染和胃十二指肠溃疡病史的长期 NSAIDs 使用者,替普瑞酮可能是治疗胃黏膜损伤和消化不良症状的有效选择。