| Objective1. To process the epidemiological investigation of CG, summarize the types of CG under gastroscope and pathology, preliminary evaluate the efficacy of clinical experiential treatment, understand the current situation of diagnosis and treatment of CG, and screen the risk factors for precancerous lesion of CG.2. To observe the efficacy of pantoprazole in combination with rebamipide for CEG, and respectively compared it to the other two groups in which the drug was used alone, sum up experiences and provide evidence for the clinical treatment of CG.Subjects and methodsSubjects:1. Outpatients with upper gastrointestinal symptoms underwent gastroscope and histopathology examination and were diagnosed as CG without other gastrointestinal diseases and systemic diseases. 2. Outpatients with upper gastrointestinal symptoms underwent gastroscope and histopathology examination and were diagnosed as CEG without other gastrointestinal diseases and systemic diseases.Methods1. Five hundred and eighty-seven outpatients who diagnosed as CG in Xiangya Hospital of Central South University from October2011to March2012were retrospectively evaluated, gastroscopic and pathologic characteristics, and the coincidence rate of gastroscope and histopathological examination were summarized. Two hundred and sixty-three outpatients were followed up, clinic symptoms, poor habits of diet, and the experiential treatment of CG were summarized; The relationship between these possible risk factors and the precancerous lesions of CG were analyzed.2. One hundred and sixteen outpatients who diagnosed as CEG in Xiangya Hospital of Central South University from March2012to March2013were randomly divided into three groups:the P group received pantoprazole40mg, once a day for4weeks; the R group received rebamipide100mg, thrice a day for4weeks; the PR group received pantoprazole(40mg once a day) in combination with rebamipide(100mg thrice a day) for4weeks. Followed up and recorded the symptoms remission and adverse reactions, observed their compliance and tolerance. After4weeks’treatment, gastroscope and histopathological examination were checked. The differences in efficacy between the three groups of drugs were compared with each other.Results1. The relationship between gender and prevalence of CG is not obvious, the most common age of CG are40to60years old, accounting for68.65%; Course length is differ, the duration of most patients is less than10years(73%); The most common type under gastroscope is CEG(69.51%); the most common location of lesions is gastric antrum (79%); Pathological results showed that the majority of patients with CG had mild-to-moderate inflammation (96.25%); active inflammation accounted for18.06%; the rate of Hp infection was19.93%; active inflammation was significantly associated with Hp infection; the detection rate of CAG under gastroscope is11.58%; the detection rate of CAG under pathologic microscope is34.24%; The coincidence rate between gastroscope and histopathological examination was74.28%. precancerous lesions were detected in207patients. The most common symptoms were epigastric pain(63.12%) and distension (60.46%). The poor habits of diet were liking spicy food(47.53%), smoking(36.88%), drinking(30.80%) and so on; Clinically commonly used drugs is in turn antacid(100%), followed by mucous membrane protective agent (75.29%); pantoprazole and omeprazole are the most commonly used antacid, accounting for30.46%and30.04%respectively. The total efficacy of experiential treatment was84.79%, the efficacy of the esomeprazole was100%, pantoprazole, omeprazole, rabeprazole, and lansopazole show equivalent clinical effects, their efficacy are84.09%,83.54%,86.84%and83.54%respectively. Course of more than10years, moderate-to-severe inflammation, smoking, being fond of spicy food were screened as risk factors for precancerous lesion of CG through single factor and multifactor logistic regression.2. After4weeks’treatment, symptoms, gastroscopic lesions and histological inflammation are obviously improved in these three groups of patients (P<0.05). The efficacy of symptoms in P group and PR group are superior to group R(P<0.05), but there were no significant differences observed in improvement of the symptoms between P group and PR groups(P>0.05). There were no significant differences observed in gastroscopic efficacy among the three groups(P>0.05). The efficacy of histological inflammation in R group and PR group are superior to group P(P<0.05), but there were no significant differences observed in histological efficacy between R group and PR groups(P>0.05).Conclusions1.The detection rate of CAG under gastroscope is11.58%; the detection rate of CAG under pathologic microscope is34.24%; The coincidence rate between gastroscope and histopathological examination was74.28%. 2. Course of more than10years, moderate-to-severe inflammation, smoking, and being fond of spicy food were screened as risk factors for precancerous lesion of CG.3. Clinical treatments of CG is diversiform, mostly follow the principle of individualized treatment; antacid and mucosal protectant are most commonly used.4. The efficacy of antacid pantoprazol is superior to the mucosal protectant rebamipide in improving symptoms for CEG patients, and the efficacy of mucosal protectant rebamipide is superior to the antacid pantoprazol in improving histopathologic inflammation for CEG patients.5. Pantoprazole in combination with rebamipide is a safe and effective solution to relieve symptoms and improve the histological inflammation for CEG patients. |
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