To observe the clinical efficacy and safety of fumarate furosemide tablets combined with mosapride tablets in the treatment of refractory non erosive gastroesophageal reflux disease (rNERD).

The rNERD patients admitted to our hospital were divided into control group (oral administration of 20 mg fumarate fumarate tablets, qd) and treatment group (addition of mosapride citrate tablets, taken before meals, 5 mg each time, tid) according to the treatment method, with a treatment course of 8 weeks. Compared the clinical symptoms, esophageal motility indicators, gastrointestinal hormone indicators, quality of life and clinical efficacy of two groups, and conducted safety evaluation.

A total of 120 patients were included, with 59 in control group and 61 in treatment group. After treatment, the gastroesophageal reflux disease scale (Gerd Q) scores of treatment group and control group were (6.89±1.29) and (7.56±1.64) points, respectively; the gastroesophageal reflux disease symptom frequency scale (FSSG) scores were (7.95±1.71) and (9.00±2.24) points, respectively; the lower esophageal sphincter pressure (LESP) were (22.19±4.33) and (19.67±4.38) mmHg, respectively; the pepsinogen Ⅰ (PG Ⅰ) levels were (121.21±26.75) and (111.57±20.28) pg·mL^-1, respectively; the pepsinogen Ⅱ (PG Ⅱ) levels were (13.58±3.17) and (15.12±3.57) pg·mL^-1, respectively; the gastrin (GAS) levels were (72.16±11.23) and (67.97±10.94) pg·mL^-1, respectively; the scores of the gastroesophageal reflux disease quality of life scale (GERD-QOL) were (32.82±7.24) and (29.75±5.37) points, respectively. The differences in the above indicators were all statistically significant between the two groups (P<0.05, P<0.01). The total clinical effective rate of treatment group was 90.16% (55 cases/61 cases), which was significantly higher than 76.27% (45 cases/59 cases) in control group (P<0.05). The adverse drug reactions in control group mainly included diarrhea, constipation and nausea; treatment group included diarrhea, constipation and dry mouth. The total incidence of adverse drug reactions in treatment group and control group were 8.20% (5 cases/61 cases) and 6.78% (4 cases/59 cases), respectively, with no statistically significant difference (P>0.05).

The combination of vonoprazan fumarate tablets and mosapride citrate tablets has a synergistic effect in the treatment of rNERD, which can effectively improve the clinical symptoms and quality of life of rNERD. Its mechanism of action may be related to multiple effects such as synergistic improvement of esophageal motility and regulation of gastrointestinal hormone levels, and the combination regimen has good safety.