Effect of Trimebutine maleate on reflux esophagitis in elderly patients
10.3760/cma.j.issn.0254-9026.2016.05.014
- VernacularTitle:马来酸曲美布汀治疗老年反流性食管炎患者中的疗效观察
- Author:
Wei WANG
;
Lei SHI
;
Le XU
- Publication Type:Journal Article
- Keywords:
Esophagitis,peptic;
Trimebutine maleate;
Proton pump inhibitors
- From:
Chinese Journal of Geriatrics
2016;35(5):511-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of Trimebutine maleate on reflux esophagitis in elderly patients.Methods A total of 160 elderly patients with typical esophageal reflux symptoms diagnosed as reflux esophagitis by gastroscope,with concomitant gastroesophageal disease confirmed by esophageal motility manometry and 24 h esophageal pH impedance monitoring acid reflux,were selected and retrospectively analyzed.All patients were treated with proton pump inhibitor(PPI) esomeprazole 20 mg tid,antecibum(AC)for 8 weeks,and randomly divided into four groups:group A (itopride hydrochloride 50 mg tid,AC),group B(citrate mosapride 5 mg tid,AC),group C (trimebutine maleate 200 mg tid,AC),group D(treated without prokinetic drugs).After 4 and 8 weeks of therapy,the symptom improvements were observed in the four groups.Endoscopy,esophageal motility manometry,24h esophageal pH impedance monitoring were performed in the 160 cases after 8 weeks of treatment.Results The total effective rate was 97.5％(39 cases),95.0％ (38 cases),92.5％(37 cases)and 77.5％(31 cases)in group A,B,C and D respectively after 8 weeks of treatment.Endoscopic examination showed that the cure rate was 70.0％ (28 cases),62.5％ (25cases),72.5％(29 cases),67.5％(27 cases),and the effective rate was 87.5％,(35 cases),92.5％(37 cases),87.5％(35 cases)and 87.5％(35 cases)in group A,B,C and D respectively after 8 weeks of treatment,without statistically significant differences in the cure rate and effective rate between the four groups.The results of esophageal motility manometry showed that the lower esophageal sphincter pressure(LESP),lower esophageal sphincter relaxation (LESR),lower esophageal peristaltic wave pressure(LEPP) and percentage of abnormal esophageal body contraction had significant difference before versus after treatment in group A and B,but not in control group.The improvements in the percentage of total time of pH＜4.0,the percentage of time of pH＜4 at standing position,the percentage of time of pH＜4 at supine position,supine reflux times,the times of supine reflux＞5 min,the longest reflux time(min)at supine position were more significant in group A,B and C than in group D.Compared with pre-treatment,the times of non-acid reflux were reduced significantly in group A,B and D(all P＜0.01),and there was a significant difference(P＜0.05)between the three (A,B,C)groups and group D(P＜0.05).There were significant differences in the times of reflux liquid and gas reflux between the group A,B and D(P＜0.05).The proximal reflux times were improved more significantly in group A,B and C after treatment than in control group(P＜0.05).Conclusions Prokinetic drugs combined with PPI therapy has better effect than single PPI application in improving the clinical symptoms and upper gastrointestinal motility in elderly patients with RE.Trimebutine maleate is safe and effective in the elderly,and has a similar effect on esophageal motility with mosapride citrate and itopride hydrochloride,which may be involved in selectively improving esophageal motility,lower esophageal sphincter pressure and gastric emptying function.
