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gastro-protecting effect of gefarnate on chronic erosive gastritis with dyspeptic symptoms

Chinese Medical Journal 2012年第16期125卷 2878-2884页

作者： Du Yi-qi SU Tun HAO Jian-yu WANG Bang-mao CHEN Min-hu LI You-ruing TANG Cheng-wei GONG Yan-fang MAN Xiao-hua GAO Li CAI Quan-cai LI Zhao-shen Department of gastroenterology Changhai Hospital Second Military Medical University Shanghai 200433 China Department of gastroenterology Department of Pathology Changhai Hospital Second Military Medical University Shanghai 200433 China Department of gastroenterology Beijing Chaoyang HospitalCapital Medical University Beijing 100020 China Department of gastroenterolog Tianjin Medical University General Hospital Tianjin 300052 China Department-of gastroenterology First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510080 China Department of gastroenterology Zhejiang First Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China Department of gastroenterology West China Hospital Sichuan University Chengdu Sichuan 610041 China

Background The role of gastro-protecting agents on symptomatic chronic gastritis is unclear. This multicenter, open, randomized trial was designed to compare the comprehensive effects of gefarnate with sucralfate on erosive gastritis with dyspeptic symptoms. Methods Totally 253 dyspepsia patients confirmed with erosive gastritis were enrolled from six centers in China. They randomly received either daily 300 mg gefarnate or 3 g sucralfate for six weeks. The primary endpoint was the effective rate of both treatments on endoscopic erosion at week six. Results Gefarnate showed an effective rate of 72% and 67% on endoscopic score and dyspeptic symptom release, which is statistically higher than sucralfate （40.1% and 39.3%, P 〈0.001, intension-to-treat）. For histological improvement, gefarnate showed both effective in decreasing mucosal chronic inflammation （57.7% vs. 24.8%, P 〈0.001, intension-to-treat） and active inflammation （36.4% vs. 23.1%, P 〈0.05, intension-to-treat） than the control. A significant increase of prostaglandins and decrease of myeloperoxidase in mucosa were observed in gefarnate group. Severity of erosion is non-relevant to symptoms but Helicobacter pylori （H. pylor status does affect the outcome of therapy. Conclusions Gefarnate demonstrates an effective outcome on the mucosal inflammation in patients with chronic erosive qastritis. Endoscopic and inflammation score should be the major indexes used in gastritis-related trials.

关键词： gefarnate gastritis," functional dyspepsia," gastro-protection

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