Efficacy of rebamipide combined with vonoprazan on the healing of artificial ulcers after endoscopic submucosal dissection
WU Chengfu
ZHANG Jingwen
LI Yang
DONG Kunlun
Abstract：Objective To observe the efficacy of rebamipide combined with vonoprazan in the treatment of artificial ulcer after endoscopic submucosal dissection(ESD).Methods A total of 106 patients with artificial ulcers after ESD admitted to the Digestive Endoscopy Center of Nanyang Second General Hospital from December 2021 to December 2024 were selected and divided into the monotherapy group and the combination group according to the random number table method,with 53 cases in each group.Patients in the monotherapy group received vonoprazan treatment,while those in the combination group received rebamipide in addition to the monotherapy regimen.Both groups received continuous treatment for 6 weeks.The ulcer healing status(including ulcer area),gastrointestinal symptom scores,36-Item Short Form Health Survey(SF-36)scores,gastrointesti-nal hormones(including gastrin and motilin),inflammatory factors(including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)),as well as the quality of ulcer healing,overall clinical effectiveness rate,and incidence of adverse reactions after treatment were compared between the two groups.Results The overall clinical response rate in the combination group was higher than that in the monotherapy group(90.57%(48/53)vs 73.58%(39/53)),and the difference was statistically significant(χ2=5.194,P<0.05).After treatment,the ulcer area in both the combination group and the monotherapy group((33.12±8.15)mm2,(41.24±7.48)mm2,respectively)was significantly smaller than those before treatment((128.45±23.23),(127.93±29.85)mm2,respectively),and the ulcer area in the combination group was smaller than that in the monotherapy group,with a statistically significant difference(t=5.344,P<0.05).After treatment,the quality of ulcer healing in the combina-tion group was higher than that in the monotherapy group(84.91%(45/53)vs 67.92%(36/53)),and this difference was statis-tically significant(χ2=4.240,P<0.05).After treatment,the gastrointestinal symptom scores in both the combination group and the monotherapy group((24.12±2.33),(26.57±3.13)points,respectively)were lower than those before treatment((34.61±4.23),(34.43±4.92)points,respectively),and the score in the combination group was lower than that in the monotherapy group,with a statistically significant difference(t=4.571,P<0.05).The SF-36 scores in the combination group and the monotherapy group((76.79±7.22),(65.51±7.24)points,respectively)were higher than those before treatment((58.71±6.30),(58.65±6.27)points,respectively),and the score in the combination group was significantly higher than that in the monotherapy group,with a statis-tically significant difference(t=8.031,P<0.05).After treatment,the levels of gastrin and motilin in both the combination group and the monotherapy group((98.25±13.32),(102.35±28.35),(120.35±15.77),(132.52±30.44)ng/L,respectively)were lower than those before treatment((141.25±18.58),(287.35±36.68),(141.32±18.66),(275.58±35.52)ng/L,respectively).Furthermore,the levels of gastrin and motilin in the combination group were lower than those in the monotherapy group,and the differences were statistically significant(t=7.794,5.245,both P<0.05).After treatment,CRP,TNF-α,and IL-6 levels in the combination group and the monotherapy group((3.24±1.54)mg/L,(24.10±3.29)pg/mL,(5.33±1.20)ng/L,(4.64±1.78)mg/L,(26.83±3.67)pg/mL,(7.56±1.25)ng/L,respectively)were lower than those before treatment((9.63±1.67)mg/L,(33.14±4.10)pg/mL,(11.21±2.13)ng/L,(9.25±1.36)mg/L,(32.95±4.23)pg/mL,(11.62±2.73)ng/L,respectively),and the levels in the combination group were lower than those in the monotherapy group(t=4.330,4.032,9.369,all P<0.05).The incidence of adverse reactions in the combination group was 13.21%(7/53),compared to 20.75%(11/53)in the monotherapy group,and the difference was not statistically significant(χ2=1.071,P>0.05).Conclusion Rebamipide combined with vonoprazan is significantly effective in treating artificial ulcers after ESD.It can effectively promote ulcer healing,improve quality of life,alleviate gastrointestinal symptoms and inflammatory re-sponses,with a good safety profile.
Keywords：rebamipidevonoprazanendoscopic submucosal dissectionartificial ulcerhealing
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：6( 447-452 )