Rabeprazole, 20 mg Once Daily or 10 mg Twice Daily,Is Equivalent to Omeprazole, 20 mg Once Daily,in the Healing of Erosive Gastrooesophageal Reflux Disease

Background: Proton pump inhibitors are the most potent pharmacologic inhibitors of gastric acid secretion currently available, and have proven effective in the treatment of gastro-oesophageal reflux disease (GERD). The object of this study was to compare the efficacy and tolerability of a new proton pump inhibitor, rabeprazole at two different dosages, with that of omeprazole in the healing of erosive GERD. Methods: Rabeprazole 20 mg once daily (QD) and 10 mg twice daily (BID) were compared with omeprazole 20 mg QD in a double-blind, multicentre, parallel group study involving 310 patients with erosive GERD. The primary efficacy endpoint was oesophageal mucosal healing determined by endoscopy. Secondary endpoints included reduction in symptoms and improvements in quality-of-life scores. Results: The healing rates between both rabeprazole groups and the omeprazole group were equivalent in both the per-protocol and intent-to-treat populations. In the per-protocol population, rabeprazole 20 mg was noted to have a numerical trend toward more rapid daytime heartburn relief. However, by 4 and 8 weeks of treatment, no significant differences were found between groups for secondary endpoints, adverse events, or laboratory abnormalities including elevation of serum gastrin levels. Conclusions: Rabeprazole 20 mg in two different dosing schedules is as effective as omeprazole 20 mg QD with regard to efficacy and tolerability in patients with erosive GERD.     

补中益气汤加减联合雷贝拉唑钠肠溶胶囊、枸橼酸莫沙必利分散片治疗反流性食管炎的临床疗效及对临床症状、生活质量的影响

目的:探讨补中益气汤加减联合雷贝拉唑钠肠溶胶囊、枸橼酸莫沙必利分散片治疗反流性食管炎的临床疗效及对患者临床症状、生活质量的影响.方法:将2019年9月至2020年9月该院收治的92例反流性食管炎患者根据随机数字表法分为两组.对照组患者(46例)服用雷贝拉唑钠肠溶胶囊、枸橼酸莫沙必利分散片治疗,观察组患者(46例)在对照...     

胃食管反流病患者雷贝拉唑52周维持治疗的多中心随访研究

背景：糜烂性食管炎（EE）和非糜烂性反流病（NERD）是胃食管反流病（GERD）两种常见的亚型,EE与NERD的关系仍存在争议。目的：探讨GERD患者雷贝拉唑52周维持治疗后2～3年随访时的反流症状、用药情况和内镜下表现变化。方法：2002年12月-2004年12月对67例EE患者和31例NERD患者行8周雷贝拉唑强化治疗和52周雷贝拉唑维持治疗,并于2～3年后随访上述患者。采用问卷调查了解患者的反流症状、用药情况,并复查内镜。结果：共随访到42例EE患者和21例NERD患者。EE患者和NERD患者所用的抑酸药类型和用药方式无明显差异。不同用药方式间患者的最严重反流症状总积分差异有统计学意义（P〈0．05）,但最近2周反流症状总积分无明显差异。与治疗前比较,EE和NERD组反流症状积分均显著改善（P〈0．01）。EE组中23例（55．0％）患者食管糜烂复发,6例（31．5％）NERD患者转变为EE;GERD患者黏膜糜烂发生率与用药方式无关。结论：52周雷贝拉唑维持治疗后2。3年随访时,GERD的反流症状仍得到控制。但质子泵抑制剂维持治疗不能预防EE复发。EE和NERD两种亚型之间可互相转化。     

雷贝拉唑联合铝碳酸镁治疗胃食管返流病临床研究

目的探讨雷贝拉唑联合铝碳酸镁治疗胃食管返流病(GERD)临床疗效。方法选取GRED患者120例,随机分为观察组与对照组各60例,对照组给予铝碳酸镁治疗,观察组在对照组基础上加用雷贝拉唑治疗,对比两组临床症状改善情况与电子胃镜复查黏膜修复情况,并进行统计学分析。结果治疗6周,临床症状改善方面,观察组总有效率为95.0%(57例),对照组总有效率78.3%(47例),两组比较差异有统计学意义(P<0.01)。复查电子胃镜结果黏膜修复情况,观察组总有效率为96.7%(58例),对照组总有效率为81.7%(49例),两组比较差异有统计学意义(P<0.01)。结论雷贝拉唑联合铝碳酸镁治疗胃食管返流病,效果显著,疗效持久稳定,安全性高,毒副作用小,在临床中广泛推广切实可行。     

Identification of the time-point which gives a plasma rabeprazole concentration that adequately reflects the area under the concentration-time curve

Objective The purpose of this study is to evaluate whether a simple formula using limited blood samples can predict the area under the plasma rabeprazole concentration-time curve (AUC) in co-administration with CYP inhibitors.Methods A randomized double-blind placebo-controlled crossover study design in three phases was conducted at intervals of 2 weeks. Twenty-one healthy Japanese volunteers, including three CYP2C19 genotype groups, took a single oral 20-mg dose of rabeprazole after three 6-day pretreatments, i.e., clarithromycin 800 mg/day, fluvoxamine 50 mg/day, and placebo. Prediction formulas of the AUC were derived from pharmacokinetics data of 21 subjects in three phases using multiple linear regression analysis. Ten blood samples were collected over 24 h to calculate AUC. Plasma concentrations of rabeprazole was measured by an HPLC-assay (l.l.q.=1 ng/ml).Results The AUC was based on all the data sets (n=63). The linear regression using two points (C3 and C6) could predict AUC_0−∞ precisely, irrespective of CYP2C19 genotypes and CYP inhibitors (AUC_0−∞=1.39×C3+7.17×C6+344.14, r ²=0.825, p<0.001).Conclusion The present study demonstrated that the AUC of rabeprazole can be estimated by the simple formula using two-point concentrations. This formula can be more accurate for the prediction of AUC estimation than that reflected by CYP2C19 genotypes without any determination, even if there are significant differences for the CYP2C19 genotypes. Therefore, this prediction formula might be useful to evaluate whether CYP2C19 genotypes really reflects the curative effect of rabeprazole.     

雷贝拉唑联合多潘立酮治疗FD的临床研究

目的:评价雷贝拉唑联合多潘立酮治疗功能性消化不良(FD)的临床疗效。方法:雷贝拉唑联合多潘立酮治疗FD患者30例,为治疗组;单用多潘立酮治疗FD患者30例,为对照组。结果:治疗组与对照组的总有效率分别为86.7%和43.3%(P<0.05)。两组患者治疗后均未发现不良反应。结论:雷贝拉唑联合多潘立酮能有效缓解FD的症状,是治疗FD安全、有效的方法。     

雷贝拉唑预防脑血管病并发急性胃黏膜病变观察

目的探讨雷贝拉唑预防急性脑血管病并发急性胃粘膜病变的作用。方法对86例急性脑血管病患者随机分成治疗组43例和对照组43例,治疗组在常规治疗的基础上根据病情轻重给予雷贝拉唑20mg,口服每日1次×15d。结果对照组12例并发急性胃粘膜病变,发病率27.9%,治疗组2例发生急性胃粘膜病变,发病率6.97%(P<0.01),对照组死亡9例,病死率20.9%,治疗组死亡2例,病死率4.65%(P<0.025)。结论雷贝拉唑预防急性脑血管病并发急性胃粘膜病变安全有效,能明显减少发病率和病死率,临床可常规应用。     

雷贝拉唑根除幽门螺杆菌的最小成本分析

目的：比较3种三联疗法根除幽门螺杆菌（却）感染的疗效和成本。方法：86例经胃镜确诊为胃或十二指肠溃疡伴阳性患者分为3组，RCF7：雷贝拉唑（R）10mg bid，、克拉霉素（C）0．5g bid、呋喃唑酮（F）0．2g bid联用7d；RAC7：R20mg bid，阿莫西林（A）1．0g bid、C0．5g bid，联用7d；RAC5：R20mg bid，A1．0g bid，C0．5g bid，联用5d。联合治疗结束后再分别予以雷贝拉唑10mg，qd，整个疗程3周。成本分析采用药物经济学的最小成本分析法。结果：3组却根除率和溃疡愈合率差异无显著性（P〈0．05），但治疗成本不同。结论：RAC5组的成本最低。     

加味左金丸联合雷贝拉唑治疗胃食管反流病的疗效观察

目的 探讨加味左金丸联合雷贝拉唑治疗胃食管反流病的临床疗效。方法 选取2021年1月—2023年3月苏州高新区人民医院收治的胃食管反流病患者100例，随机分为对照组（50例）和治疗组（50例）。对照组患者口服雷贝拉唑肠溶胶囊，1次/d，20 mg/次。治疗组患者在对照组基础上口服加味左金丸，2次/d，6 g/次。两组均连续治疗8周。观察两组患者临床疗效，比较治疗前后两组患者临床症状和SF-36量表评分及食管括约肌静息压。结果 治疗后，治疗组总有效率为90.00%，明显高于对照组（74.00%，P＜0.05）。治疗后，两组反流性疾病问卷（RDQ）总分、烧心、反食、反酸、胸部不适评分均明显降低，而总体健康、生理功能、生理职能、社会功能、情感职能、躯体疼痛、生命活力、心理健康评分明显升高（P＜0.05），且治疗组临床症状和SF-36量表评分明显好于对照组（P＜0.05）。治疗后，两组患者食管下括约肌（LES）静息压和食管上括约肌（UES）静息压明显升高（P＜0.05），且治疗组明显高于对照组（P＜0.05）。结论 加味左金丸联合雷贝拉唑治疗胃食管反流病具有较好的疗效，可改善患者的临床症状和生活质量，增加食管括约肌静息压。     

应激性溃疡大鼠延髓内脏带NSE的表达及雷贝拉唑预处理的影响

目的探讨复合性刺激导致胃溃疡对大鼠延髓内脏带(MVZ)NSE表达的影响,以及雷贝拉唑预处理后的变化。方法将48只大鼠随机分为应激组(20只)、预处理组(20只)和对照组(8只)。先建立动物模型:应激组和预处理组于应激前半小时分别用生理盐水和雷贝拉唑灌胃,大鼠在(19±1)℃水中力竭性游泳1h后,四肢捆绑在鼠板上垂直浸入冷水中6h,对照组1ml生理盐水灌胃不加应激。延髓冰冻切片后用ABC法检测NSE的表达,胃窦部行石蜡切片HE染色。结果应激组胃黏膜有局灶性出血和脱落,并且MVZ内观察到NSE阳性神经元,预处理组胃黏膜病理改变不显著,MVZ的NSE阳性神经元数量明显减少,对照组胃黏膜和MVZ基本正常。结论①力竭性游泳加冷束缚应激可导致胃黏膜产生应激性溃疡;②应激性溃疡与MVZ的诱导有关联性;③雷贝拉唑能有效预防应激性溃疡的发生,并推测可能参与了MVZ的调节过程。