吉法酯预防小剂量阿司匹林致消化道溃疡再出血的临床研究

目的：比较吉法酯联合短期使用埃索美拉唑与分别长期单独使用吉法酯、埃索美拉唑预防小剂量阿司匹林相关性溃疡复发的疗效和安全性。方法：123倒服用小剂量阿司匹林致消化性溃疡出血的患者，经6—8周治疗溃疡愈合后，按入院先后顺序分为A组（吉法酯片100mg，po tid，长期服用）、B组（埃索美拉唑片20mg，po qd，长期服用）、C组（吉法酯100mg，Potid，长期服用＋埃索美拉唑片20mg，poqd，前8周服用），比较3组患者治疗0-8周、9—50周再出血发生率和不良反应发生率。结果：治疗8周后，3组患者再出血发生率比较，C组明显低于A、B两组，差异有统计学意义（P〈0．05）；治疗50周后，3组患者首次再出血发生率比较，差异无统计学意义（P〉0．05）。治疗8周后，3组患者不良反应的发生率比较，差异无统计学意义（P〉0．05）；治疗50周后，3组患者不良反应比较，A、c两组患者不良反应发生率明显低于B组，差异有统计意义（P〈0．05）。结论：患者短期应用埃索美拉唑联合吉法酯治疗后，再予以吉法酯维持治疗的方法，对预防及治疗小剂量阿司匹林所致渍疡及出血，能够达到与长期应用质子泵抑制药（PPI）相同的治疗效果，还可避免长期应用PPI所引起的临床并发症。

Clinical Research of Gefarnate Prevention of the Digestive Tract Ulcer Bleeding Caused by Low-dose Aspirin

Objective：To compare the efficacy and safety of the short treatment with gefarnate and gefarnate in combination with esomeprazole and the long treatment with gefarnate and esomeprazole alone to prevent patients＇ ulcers and bleeding due to the use of low-dose aspirin. Methods： 123 cases of patients were selected to take low-dose aspirin to treat their peptic ulcer bleeding. 6-8 weeks after the treatment of ulcer healing according to their admission order, they were divided into Group A （gefarnate 100rag, po rid, long-term use） and Group B （esomeprazole 20mg, po qd, long-term use） and Group C （gefarnate 100mg, po rid, long-term use ＋ esomeprazole 20mg, po qd, taking 8 weeks）. Their incidence of bleeding and incidence of adverse reactions were compared in the periOds of 0 -8 and 9-50 weeks. Results：8 weeks after the treatment the incidence of their rebleeding was 34.2% for Group A, 17.5% for Group B and 2.2% for Group C with significant difference（ P 〈 0.05 ）. Its incidence of rebleeding was obviously lower than that of Groups A and B. 50 weeks after the treatment, the incidence of bleeding respectively was 15.8% for Group A , 10% for Group B and 11.1% for Group C. There were not any significant differences （P 〉 0.05 ） in the three groups. Conclusion：Mter the short-term treatment with esomeprazole in combination with gefarnate, the maintenance treatment methods with gefarnate could achieve the same therapeutic effect as PPI（ proton pump inhibitors） on the prevention and treatment of ulcers and bleeding due to low-dose aspirin, and could also reduced the complications caused by the long use of PPI .