埃索美拉唑治疗胃食管反流病与奥美拉唑对照研究

目的探讨埃索美拉唑治疗胃食管反流病(GERD)的临床疗效.方法把60例GERD患者随机分为两组埃索美拉唑组与奥美拉唑组.治疗前进行症状(烧心、反酸和胸痛)分级评分与内镜检查分级,治疗后8周有46例复查内镜并进行分级.结果症状分级评分埃索美拉唑组缓解率(92.3%)明显高于奥美拉唑组(78.1%),两组比较差异有显著性(P＜0.05);内镜检查分级埃索美拉唑组治愈率88.0%,高于奥美拉唑组61.9%,但两组比较差异无显著性(P＞0.05),可能与观察例数过少有关.结论埃索美拉唑治疗GERD优于奥美拉唑,是治疗GERD的理想药物之一.     

埃索美拉唑治疗胃食管反流病临床对照观察评价

目的评价埃索美拉唑（esomeprazole）治疗胃食管反流病（GERD）的临床疗效。方法随机将130例确诊的GERD患者分为两组,治疗组70例,给予埃索美拉唑40mg,口服,1次／天;对照组60例,给予兰索拉唑30mg,口服,1次／天,疗程均为8周。记录治疗后患者烧心、嗳气、反酸、胸骨后灼痛等症状积分改变,按症状积分改善及内镜检查结果对比分析疗效。结果治疗组GERD症状积分改善优于对照组,前2周,P〈0．01,4周时P〈0．05,食管黏膜损害愈合率,治疗组优于对照组分别为74．3％和61．7％,P〈0．01,但总有效率分别为95．7％和93．3％,P〉0．05,两组差异无显著统计学意义。结论埃索美拉唑是治疗胃食管反流病速效高效且安全的质子泵抑制剂（PPI）。     

莫沙必利联合埃索美拉唑治疗胃食管反流病的研究

目的 观察莫沙必利联合埃索美拉唑治疗胃食管反流病(GERD)的临床效果.方法 随机抽取有典型症状的GERD患者40例行胃食管反流症状评估、内镜评估、24h食管pH监测、以及高分辨率食管测压,对比研究莫沙必利联合埃索美拉唑和单用埃索美拉唑各8周治疗对GERD症状的改善,以及对食管pH和食管运动功能的影响.结果 与对照组治疗相比,莫沙必利联合埃索美拉唑治疗降低胃食管反流总症状评分更明显,可改善食管运动、降低食团内压(IBP),减少食管下端pH＜4总反流次数,降低pH＜4总时间百分比,差异均有统计学意义(P＜0.05).结论 莫沙必利联合埃索美拉唑治疗,能改善胃食管反流症状,降低食管反流,改善食管运动,是一种更有效的治疗GERD方案.     

埃索美拉唑联合盐酸依托必利治疗胃食管反流病26例临床分析

胃食管反流病(gastroeso phageal reflux disease,GRED)分为内镜阳性GERD和内镜阴性GERD。内镜检查发现食管黏膜有破损者为反流性食管炎。2008年1月—2008年12月本文作者选择26例用质子泵抑制剂(除外埃索美拉唑)4周后     

埃索美拉唑治疗胃食管反流病临床疗效观察

目的观察埃索美拉唑与莫沙必利联合治疗胃食管反流病（GERD）的疗效。方法将83例GERD患者随机分为2组,治疗组44例,给予埃索美拉唑40mg／d,莫沙必利5nag,3次／d,口服;对照组39例,给予奥美拉唑20nag,2次／d．莫沙必利5mg,3次／d,口服。于治疗后1,4,8周观察临床症状缓解情况以及8周后胃镜复查结果。结果治疗组症状改善、胃镜检查结果明显优于对照组（P〈0．05）。结论埃索美拉唑与莫沙必利联用是治疗胃食管反流病的有效方案。     

胃食管反流病食管外症状的食管酸暴露特点及埃索美拉唑镁肠溶片的治疗价值

目的：研究胃食管反流病食管外症状的食管酸暴露特点，探讨埃索美拉唑镁肠溶片对食管外症状的治疗价值。方法：32例具有食管外症状的GERD患者分成三组，异常酸反流组14例，食管对酸高敏组16例，功能性上腹灼痛组2例，并以埃索美拉唑镁肠溶片20mg，2次／d治疗8周。结果：异常酸反流组酸反流次数、长时间酸反流次数、pH〈4，时间百分比较其他两组明显增加；食管对酸高敏组食管外症状指数显著高于功能性上腹灼痛组，P〈0．05；治疗前食管对酸高敏组食管外症状积分明显高于异常酸反流组；治疗后4、8周，异常酸反流组、食管对酸高敏组的症状积分显著下降，而功能性上腹灼痛组患者仅有下降趋势，与治疗前比较差异无统计学意义（P〉0．05）。埃索美拉唑镁肠溶片对GERD患者食管外症状4、8周治疗后的有效率分别为71％和80％。结论：食管对酸高敏患者可能更易发生食管外症状；埃索美拉唑镁肠溶片对GELID患者食管外症状有较好的治疗效果。     

埃索美拉唑治疗胃食管反流病36例疗效观察

目的:观察埃索美拉唑治疗胃食管反流病(GERD)的临床疗效。方法:将68例GERD患者随机分为两组:治疗组36例与对照组32例,治疗前进行症状(烧心、反酸和胸痛)分级评分与内镜检查分级,治疗8周后复查内镜并进行分级。结果:症状分级评分,治疗组缓解率91.66%,明显高于对照组缓解率71.87%,两组比较差异有显著性(P<0.05);内镜检查分级,治疗组治愈率88.88%,高于对照组78.12%,但两组比较差异无显著性(P>0.05),可能与观察例数过少有关。结论:埃索美拉唑治疗GERD,疗效优于奥美拉唑,是治疗GERD的理想的选择药物之一。     

埃索美拉唑联合莫沙必利片治疗胃食管反流病疗效观察

胃食管反流病（GERD）是指胃或十二指肠内容物反流入食管导致的一系列慢性症状或组织损害,反流导致的食管粘膜受损称为反流性食管炎（RE）。消化内镜检查是RE的主要诊断方法。因此,可分为内镜阳性GERD和内镜阴性GERD。内镜检查发现食管粘膜有破损者为RE。反流性食管炎是一种常病,其发病机制主要是由于抗反流防御屏障功能减弱和反流物对食管粘膜攻击作用的结果 [1]。药物治疗以抑酸及促进胃动力为主。作者近年来联合应用埃索美拉唑、莫沙必利分散片治疗GERD,取得了满意疗效,报告如下。     

埃索美拉唑治疗胃食管反流病38例疗效观察

目的观察评价埃索美拉唑治疗胃食管反流病(GERD)的临床疗效。方法将68例GERD患者随机分为埃索美拉唑治疗组38例和法莫替丁对照组30例,二组均加用莫沙必利,疗程8周,比较二组的疗效差异。结果埃索美拉唑组与法莫替丁组治疗GERD8周后临床症状改善的总有效率分别为89.47%、63.33%,内镜下总有效率分别为92.11%、76.67%,差异有统计学意义(P<0.05)。结论埃索美拉唑治疗GERD疗效确切,不良反应小,值得临床推广。     

埃索美拉唑治疗胃食管反流病疗效观察

目的探讨埃索美拉唑治疗胃食管反流临床疗效及安全性。方法将2010年6月～2011年6月在我院接受治疗的92例GERD患者随机分为观察组和对照组,两组均给予常规治疗,观察组在常规治疗基础上给予埃索美拉唑口服治疗,对照组给予奥美拉唑口服治疗,观察两组患者治疗4周后临床疗效。结果观察组治疗后烧心、反酸、胸骨后疼痛症状积分明显低于对照组,组间比较有显著差异（P〈0．05）;观察组有效率为95,65％,明显高于对照组的76．09％,组间比较有显著差异（P〈0．05）。结论埃索美拉唑治疗GERD具有抑酸能力强、药效持久、不良反应少等优点,是目前治疗GERD的一种较佳药物。     

Dilated intercellular spaces in gastroesophageal reflux disease patients and the changes of intercellular spaces after omeprazole treatment

Background Gastroesophageal reflux disease （GERD） is a common disorder. Dilation of intercellular spaces of esophageal epithelium has been revealed at transmission electron microscopy both in the rabbit acid-perfused esophagus and in esophageal biopsies from GERD patients. This study aimed to observe the changes of the intercellular spaces of squamous epithelium of lower esophagus in patients with GERD and the changes of intercellular spaces of patients with erosive esophagitis （EE） before and after omeprazole treatment.
Methods Outpatients having GERD symptoms for more than 3 months and volunteers were collected. All of them underwent gastroendoscopy and 24-hour ambulatory pH monitoring. Biopsies were taken from the lower esophagus （2 cm above Z-line） for electron microscope examination. Five healthy volunteers, six non-erosive reflux disease （NERD） patients, and five EE patients were enrolled. Intercellular spaces of GERD patients and controls were calculated. Then we selected 20 patients with EE diagnosed by gastroendoscopy. All of them were treated with omeprazole （Losec, 20 mg bid） for 4 weeks then underwent gastroendoscopy again. Biopsies were taken from 2 cm above Z-line for electron microscope examination. All the patients completed the questionnaire about reflux symptoms before and after treatment.
Results Intercellular spaces of esophageal epithelial cell in volunteers, NERD patients and EE patients were （0.37±0.07）μm, （1.31±0.08）μm, and （1.33±0.14）μm, respectively, with significant differences between the control group and the NERD group （P=0.000）. In the 20 EE patients, the mean intercellular space before treatment was （1.14±0.15） μm After treatment the intercellular space was （0.51±0.18）μm, a significant difference compared with pre-treatment measurements （P=0.000）. Conclusions Dilated intercellular spaces （DIS） were seen in both NERD and EE cases. The dilated intercellular spaces of esophaaeal epithelium in EE patients could be recove     

Relationship between symptom response and the esophageal pH level on standard dose of esomeprazole treatment for gastro-esophageal reflux disease

Objective To evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese gastro-esophageal reflux disease (GERD) patients on esomeprazole therapy, and to assess the role of 24-hr esophageal pH-metry after therapy in GERD patients. Methods GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hr esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hr pH-metry after treatment; the pH- group achieved normalization of esophageal pH level whereas the pH+ group did not. Results Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 89.7% (52/58) of symptom-free patients and 66.7% (12/18) of symptom-persistent patients achieved esophageal pH normalization after therapy (P=0.030). The mean post-therapy gastric nocturnal % time of pH< 4 was significantly higher in pH+ group than that in pH- group (P<0.001) after therapy. The multivariate regression analysis identified hiatus hernia (P<0.001) and persistent reflux symptom (P=0.004) were 2 independent factors predicting the low post-therapy esophageal pH level. Conclusion Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse. Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.     

坦度螺酮联合埃索美拉唑治疗非糜烂性反流病伴焦虑的疗效分析

目的：探讨坦度螺酮联合埃索美拉唑治疗非糜烂性反流病（ NERD）伴焦虑患者的疗效及安全性。方法将86例NERD伴焦虑患者按随机数字表法分为两组各43例。观察组口服埃索美拉唑镁联合坦度螺酮,疗程8周;对照组口服埃索美拉唑镁,疗程8周。分别于治疗前及治疗2、4、6、8周后测定两组胃食管反流病问卷表（ GERD Q ）、Zung焦虑自评量表（SAS）、Zung 抑郁自评量表（SDS）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分,记录两组不良反应发生情况。结果观察组GERD Q、SDS、SAS、HAMA、HAMD评分总体均随着时间的延长呈下降趋势（P＜0．05）,且治疗后观察组各项评分均低于对照组（P＜0．05）;观察组不良反应发生率为9．3％（4／43）,与对照组的4．7％（2／43）比较,差异无统计学意义（P＞0．05）。结论坦度螺酮联合埃索美拉唑治疗NERD伴焦虑状态疗效确切,可作为常规质子泵抑制剂或抗反流治疗失败时的另一种选择。     

Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease

Background The relationship between symptom elimination and normalization of esophageal acid level of gastroesophageal reflux disease （GERD） on proton-pump inhibitor （PPI） therapy has been questioned. This study aimed to evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese patients with GERD on esomeprazole therapy, and to assess the role of 24-hour esophageal pH-metry after therapy in GERD patients.Methods GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hour esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hour pH-metry after treatment. The pH- group achieved normalization of esophageal pH level whereas the pH＋ group did not.Results Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 90% （52/58） of symptom-free patients and 67% （12/18） of symptom-persistent patients achieved esophageal pH normalization after therapy （P=0.030）. The mean post-therapy gastric nocturnal percent time of pH 〈4.0 was significantly higher in pH＋group than that in pH- group （P 〈0.001） after therapy. The multivariate regression analysis identified hiatus hernia （P〈0.001） and persistent reflux symptom （P=0.004） were two independent factors predicting the low post-therapy esophageal pH level.Conclusions Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse.Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.     

胃食管反流病症状谱及危险因素

目的:探讨胃食管反流病(gastroesophageal reflux disease,GERD)症状谱,分析与之相关的危险因素。方法:以南充市中心医院消化内科门诊及胃镜室确诊的GERD患者为病例组,以健康体检者及无烧心、反酸等典型症状且内镜检查为慢性浅表性胃炎者为对照组,采用问卷调查收集GERD患者就诊的主要症状,分析GERD的相关症状谱及危险因素。结果:共收集病例组370例,对照组347例。GERD症状谱系广泛、多样化,临床表现以烧心、反流症状为主,分别占84.05%和70.00%;RE组与NERD组患者主要相关症状发生率比较差异无统计学意义(P>0.05)。低教育水平、吸烟、喜高脂食物、便秘、肥胖、食管裂孔疝等可能是GERD的危险因素。结论:GERD以烧心、反流为主要表现,RE与NERD临床表现相似,吸烟等多种危险因素与GERD发病有关。     

烧心患者的临床类型及特征分析

目的罗马Ⅲ标准提出了非糜烂性反流病（NERD）和功能性烧心（FH）的诊断标准。根据该标准,结合胃镜、食管pH监测及质子泵抑制剂（PPI）试验,探讨烧心患者临床类型及特征。方法62例连续就诊的烧心患者填写症状问卷后全部行内镜检查,对内镜阴性的患者进行24h食管pH监测,计算症状指数（sI）,随后全部患者完成PPI试验（埃索美拉唑20mg,每天2次,14d）：结果反流性食管炎（RE）16例,NERD和FH分别为39例、7例;NERD又可分3个亚型,pH监测正常的NERD与FH仍存在多项参数的差异：内镜阴性患者中PPI试验阳性组与阴性纽的pH监测值比较差异无统计学意义（x2=2．681,P=0．102）。结论烧心患者可分为RE、NERD和FH三类,NERD和FH是临床特点不同的异质性疾病。     

埃索美拉唑治疗胃食管反流病患者的临床疗效观察

目的观察埃索美拉唑治疗胃食管反流病(GERD)的临床疗效。方法将86例GERD患者随机分为治疗组和对照组各43例。在常规治疗基础上,治疗组加用埃索美拉唑40mg,口服,qd;对照组予相同剂量的安慰剂治疗,口服,qd。治疗4周后比较两组患者的症状改善情况,主要指烧心、反酸以及由此并发的反流性食管炎的愈合情况。结果治疗组显效33例,有效6例,无效4例;对照组显效8例,有效3例,无效32例,两组疗效间差异有统计学意义(P0.05)。治疗组较对照组患者治疗后烧心、反酸症状的改善情况具有显著的统计学意义(P0.05),在初诊时具有反流性食管炎的患者经治疗组和对照组治疗4周后胃镜复查食管炎的改善情况具有显著性差异(P0.05)。两组患者治疗中均未发生严重的不良反应。结论埃索美拉唑治疗胃食管反流病(GERD)安全、有效,能显著改善该类患者的临床症状。     

埃索美拉唑联合莫沙必利治疗反流性食管炎的疗效观察

目的:探讨埃索美拉唑联合莫沙必利治疗反流性食管炎的临床疗效。方法:将94例反流性食管炎患者随机分成3组,对照组Ⅰ、Ⅱ组分别单纯服用埃索美拉唑和莫沙必利,治疗组同时服用埃索美拉唑和莫沙必利,评价其疗效差异。结果:治疗前3组反流性食管炎患者的反酸、烧心、咽下困难以及胸骨后灼痛的症状积分比较差异无统计学意义(P>0.05),经过治疗4周后,症状积分均较治疗前显著降低(P<0.05),且治疗组明显低于对照组,差异有统计学意义(P<0.05)。治疗4周后,治疗组总有效率显著高于对照组(P<0.05),而其不良反应发生率明显低于对照组(P<0.05)。结论:埃索美拉唑与莫沙必利的联合应用具有协同作用,起效快、疗效好,不良反应少,安全可靠。