Gastric mucosal protectors are mainly divided into 2 categories, exogenous and endogenous. Our common sucralfate, colloidal pectin bismuth, bismuth citrate potassium and so on belong to exogenous gastric mucosal protectors. Endogenous gastric mucosal protectors mainly include tipreone, rebapist, isolatine, etc., mainly by stabilizing cell membranes, increasing submucosal protective factors, increasing mucosal blood flow, antioxidant and other mechanisms. Through the different targets acting on the gastric mucosal barrier, it exerts a comprehensive protective effect.
Tipridone
Tipuridone can promote the synthesis of polymer glycoproteins in the gastric mucosa, improve mucus concentration, promote mucosal repair, improve the defense function of mucosa, and strengthen anti-ulcer effect. It can also promote the synthesis of local endogenous prostaglandins by increasing the content of NO synthase and NO in mucosal tissues, upregulate the expression of heat shock protein 70, and promote defense and mucosal repair. It is mainly used for acute gastritis, acute exacerbation of chronic gastritis, gastric mucosal lesions, such as erosion, bleeding, flushing, edema improvement, and gastric ulcers.
The drug does not affect the normal physiological function of the stomach, such as gastric juice secretion and gastric motor function. It has a cytoprotective effect on hydrochloric acid, aspirin and alcohol-induced ulcers. It can also improve the proliferation ability of cells in the gastric mucosal proliferation area caused by the hormone hydrocortisone, maintain the stability of the gastric mucosal cell proliferation area, and promote damage healing. It can also improve the synthesis capacity of prostacyclin in the mucosa between the stomach and pylorus of normal rats, and improve the low blood flow of gastric mucosa caused by blood loss stress and fixed water immersion stress.
Ribapat
Ribapete has the effect of protecting the gastric mucosa and promoting ulcer healing. Its main pharmacological effects include: reducing Helicobacter pylori (Hp) infection: the drug does not directly inhibit Helicobacter pylori, but is used to treat Hp infection by preventing Hp from adhering to gastric epithelial cells, reducing oxidative stress, reducing the concentration of cytokines produced by Hp, etc. Effect of scavenging radicals: Protects gastric mucosal damage caused by free radicals by reducing lipid peroxidation. Inhibits inflammatory cell infiltration.
In addition, animal experiments have shown that the amount of gastric mucus, blood flow of gastric mucosa and gastric mucosal prostaglandin content in rats can be increased, and the regeneration of gastric mucosal cells in rats can be promoted, and the secretion of alkaline substances in the stomach can be increased. However, the drug has little effect on the secretion of basal gastric juice, and the secretion of gastric acid caused by stimuli such as food has not been shown to inhibit. It is mainly used for gastric ulcers, but should not be used alone for Hp infection. It is also used to improve gastric mucosal lesions in acute gastritis and chronic gastritis, such as erosion, bleeding, congestion, edema, etc.
Isoladin
Isoratine can strengthen the tight connection of mucosal epithelial cells, prevent harmful substances from passing through the mucous membrane, improve the content of cyclic adenosine phosphate, prostaglandin and mucosal glycoprotein in gastric mucosal cells, and can also increase the content of nitric oxide and aminohexose, inhibit the production of inflammatory factors such as tumor necrosis factor - α, inhibit the free radicals produced by neutrophils, and play an antioxidant role.
Animal experiments have shown that the drug can inhibit ulcers caused by hydrochloric acid, ethanol, indomethacin, histamine and aspirin, and has the effect of increasing blood flow to the gastric mucosa, promoting the healing of chronic gastric ulcers, and its pharmacological effect is dose-dependent. For gastric ulcers. It is also used to improve gastric mucosal lesions during acute exacerbations of acute gastritis and chronic gastritis, such as erosions, bleeding, congestion, edema, etc.
In recent years, animal studies have shown that such drugs not only protect the gastric mucosa, but also protect the damage to the small intestinal mucosa caused by the drug. Tipredone protects the intestinal mucosa from the risk of ulceration caused by sodium lozoprofen and damage to the epithelial barrier of the small intestine by increasing the mucin content in the mucosa of the small intestine of rats, the content of the mucosal vascular endothelial growth factor, and alleviating free radical damage.
In animal studies of small intestinal mucosal damage caused by indomethacin, ribapide relieves small intestinal mucosal injury by inhibiting inflammatory factors, increasing serum prostaglandin E2, epidermal growth factor levels, and increasing the expression of triloba factor 3 in the small intestine; the protective effect of isoratine may be related to increased mucus secretion or inhibitory effect on phosphodiesterase.
A multicenter, randomized, double-blind controlled study of patients with gastrointestinal mucosal injury due to sodium diclofenac was found to be effective in preventing gastrointestinal mucosal damage caused by sodium diclofenac. Rebapiter not only has a healing effect on gastrointestinal mucosal damage caused by low-dose aspirin and other nonsteroidal anti-inflammatory drugs, but also increases serum albumin levels and improves nutritional status. Short-term use of Isola is more effective in suppressing gastrointestinal mucosal damage caused by NSAIDs than omeprazole.
In conclusion, in the treatment of erosive gastritis caused by various etiologies, the efficacy of mucosal protectors is comparable to that of PPI (XXprazole). In relieving symptoms such as bloating and belching, mucosal protectors are better than PPIs. Endogenous mucosal protectors such as tipradone, rebapiter, and isolatine have a therapeutic course of 4 weeks, which are significantly better than those of 2 weeks, and can effectively improve gastrointestinal mucosal erosion, bleeding, congestion, edema, etc., and eliminate common digestive tract symptoms.