| Background and aim: Endoscopic submucosal dissection(ESD)has become a common method for the treatment of early gastric cancers and precancerous lesions.However,ESD can result in artificial gastric ulcers,how to promote the ESD-induced artificial gastric ulcers healing is common concern.At present,proton pump inhibitor(PPI)is the preferred choice for ESD-induced artificial gastric ulcers.In recent years,it has been reported that PPI and gastric mucosal protective agent can improve the healing rate and the healing quality of ulcers when compared with PPI monotherapy.However,very few studies have been reported that gastric mucosal protective agents monotherapy were used to treat ESD-induced artificial gastric ulcers.Only few studies about rebmipide and ecabet sodium monotherapy for treating ESD-induced artificial gastric ulcers were reported in foreign countries.There is no such study in our country,and no study on teprenone monotherapy treating ESD-induced artificial gastric ulcers in foreign countries.Therefore,this study is performed to assess the efficacy and the medication cost of teprenone monotherapy compared with lansoprazole monotherapy for ESD-induced artificial gastric ulcers,and to explore a innovative,efficient and economical therapy.Method: This study was a prospective,randomized,controlled clinical trial.Total 30 patients receiving ESD were recruited from The Sixth Hospital Affiliated to Guangzhou Medical University-Qingyuan People's Hospital from March 2017 to February 2018.All patients were administered an intravenous infusion of the PPI lansoprazole 30 mg every 12 h for 3d,followed by lansoprazole capsule 30mg/d for 4d orally.On postoperative day 8,all the patients were randomly assigned to 2 groups and reveived either teprenone monotherapy(50mg orally,three times a day;n=15;teprenone group)or lansoprazole monotherapy(30mg orally,once a day;n=15;lansoprazole group).After grouping,the treatment durations were both 7 weeks.After ESD,we assessed the ulcer outcomes and occurrence of complications,and at 4th and 8 week after ESD,an esophagogastroduodenoscopy exam were performed for all patients to evaluateulcer healing.Result: At 4 week,there was no significant differences between two groups in terms of the proportions of ulcer reduction(0.9224±0.1365 in the teprenone group vs 0.9464±0.0545 in the lansoprazole group,P=0.533).At both 4 and 8 week,the healing rates of ESD-induced artificial gastric ulcers were similar in the teprenone-treated and the lansoprazole-treated patients(4 week:teprenone,28.57%;PPI,20.00%;P=0.682;8 week: teprenone,92.86%;PPI,80.00%;P=0.598),and the improvement rates of two groups had the same outcomes(4 week: teprenone,78.57%;PPI,60.00%;P=0.427;8 week: teprenone,100%;PPI,93.33%;P=1.00).At 8 week after ESD,the proportions of flat scar ulcers in the teprenone group(64.29%)was higher than in the lansoprazole group(20.00%,P=0.025).The medication cost of 8-week treatment with lansoprazole was 547.06 yuan vs 344.42 yuan for teprenone.No delayed post–ESD bleeding or delayed perforation in either group.Conclusion: Teprenone monotherapy is as effective as lansoprazole monotherapy for treating ESD-induced artificial gastric ulcers.However,teprenone monotherapy can improve the quality of ulcer healing and is more cost-effective. |
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