埃索美拉唑治疗小儿胃食管反流临床观察

胃食管反流(gastro蛳oesophagealreflux disease,GERD)是指胃内容物,包括从十二指肠流入胃的胆盐和胰酶等反流入食管,分生理性和病理性2种。病理性反流是由于食管下括约肌功能障碍和(或)与其功能有关的组织结构异常,以至食管下括约肌压力低下而出现的反流,引起一系列如上腹痛、烧心、泛酸等临床症状。GERD是一种潜在的、较严重的长期疾病,不论有无食管炎的发生,它对人的生活质量有不同程度的不良影响。本研究目的是确认埃索美拉唑改善小儿GERD症状的疗效,同时评价药物在GERD小儿中应用的安全性和耐受性。1对象与方法1.1临床资料收集2…     

慢性咳嗽68例临床分析

目的 分析慢性咳嗽患者的病因分布。方法 对68例慢性咳嗽患者进行前瞻性研究。常规行X线胸片、肺功能、食道内镜、痰检查及血液学检查。必要时查支气管激发试验、24h食道PH值监测、鼻窦CT、纤维支气管镜及纤维鼻咽镜。根据临床表现、检查结果及特异性治疗疗效作最后诊断。结果 病因依次为咳嗽变异型哮喘30例，44．1％、鼻后滴流综合征21例，30．9％；胃食管反流病13例，19．1％；支气管结核2例，2，9％；真菌感染1例，1．5％；嗜酸细胞性支气管炎1例，1．5％。结论 慢性咳嗽最常见的病因为咳嗽变异型哮喘、鼻后滴流综合征及胃食管反流病。     

半夏泻心汤为主治疗胃食管反流性咽喉炎40例临床观察

目的:观察以半夏泻心汤为主治疗胃食管反流病(GERD)引起的咽喉炎.方法:治疗组40例以半夏泻心汤为主治疗,对照组38例给予金嗓利咽丸治疗.结果:两组咽喉炎并发症疗效、GERD症状疗效、胃镜分级疗效、喉镜检查比较,治疗组明显优于对照组(P＜0.05或P＜0.01).结论:半夏泻心汤为主治疗胃食管反流病引起的咽喉炎具有较好疗效.     

胃食管反流病致重度牙齿侵蚀的固定-活动联合修复

目的:探讨用固定-活动义齿联合修复,对胃食管反流病致重度牙齿侵蚀症患者进行咬合重建的临床效果。方法:对从2010年1月~2013年10月来我院就诊的10例胃食管反流病致重度牙侵蚀症患者采用诊断义齿过渡3~6个月,患者适应后再以诊断义齿为依据,采用固定-活动联合修复行咬合重建。分别于修复后3个月、6个月、1年、2年、3年复查。复查内容:修复体完整性、咬合稳定性、美观度、患者使用满意度。结果:整个随访期间,10例咬合重建患者面部外形改善,咀嚼功能恢复良好,患者对义齿的美观及舒适性均较为满意,配合用药后食管反流症状基本消失。结论:用固定-活动义齿联合修复,进行牙合重建能恢复患者美观,提高咀嚼功能同时后期维护简便。     

巨大肺大疱伴胃食管反流1例

肺大疱在临床工作中常见,但是巨大肺大疱伴胃食管反流症状的患者较少见.巨大肺大疱易被误诊为气胸,如果伴有胃食管反流症状,易误诊为胃食管反流性哮喘,本例患者经过正确诊断和手术治疗痊愈,对我们拓宽胃食管反流症状病因的思考非常重要.     

Endoscopic anti-reflux therapy for gastroesophageal reflux disease

Gastroesophageal reflux disease has an increasing incidence and prevalence worldwide. A significant proportion of patients have a suboptimal response to proton pump inhibitors or are unwilling to take lifelong medication due to concerns about long-term adverse effects. Endoscopic anti-reflux therapies offer a minimally invasive option for patients unwilling to undergo surgical treatment or take lifelong medication. The best candidates are those with a good response to proton pump inhibitors and without a significant sliding hiatal hernia. Transoral incisionless fundoplication and nonablative radiofrequency are the techniques with the largest body of evidence and that have been tested in several randomized clinical trials. Band-assisted ligation techniques, anti-reflux mucosectomy, anti-reflux mucosal ablation, and new plication devices have yielded promising results in recent noncontrolled studies. Nonetheless, the role of endoscopic procedures remains controversial due to limited long-term and comparative data, and no consensus exists in current clinical guidelines. This review provides an updated summary focused on the patient selection, technical details, clinical success, and safety of current and future endoscopic anti-reflux techniques.     

Acid peptic diseases: pharmacological approach to treatment

Acid peptic disorders are the result of distinctive, but overlapping pathogenic mechanisms leading to either excessive acid secretion or diminished mucosal defense. They are common entities present in daily clinical practice that, owing to their chronicity, represent a significant cost to healthcare. Key elements in the success of controlling these entities have been the development of potent and safe drugs based on physiological targets. The histamine-2 receptor antagonists revolutionized the treatment of acid peptic disorders owing to their safety and efficacy profile. The proton-pump inhibitors (PPIs) represent a further therapeutic advance due to more potent inhibition of acid secretion. Ample data from clinical trials and observational experience have confirmed the utility of these agents in the treatment of acid peptic diseases, with differential efficacy and safety characteristics between and within drug classes. Paradigms in their speed and duration of action have underscored the need for new chemical entities that, from a single dose, would provide reliable duration of acid control, particularly at night. Moreover, PPIs reduce, but do not eliminate, the risk of ulcers in patients taking NSAIDs, reflecting untargeted physiopathologic pathways and a breach in the ability to sustain an intragastric pH of more than 4. This review provides an assessment of the current understanding of the physiology of acid production, a discussion of medications targeting gastric acid production and a review of efficacy in specific acid peptic diseases, as well as current challenges and future directions in the treatment of acid-mediated diseases.     

姜树民教授治疗胆汁反流性胃炎经验

胆汁反流性胃炎是因十二指肠液反流入胃所致的以胃黏膜损害为病理表现的疾病。属于祖国医学之胃脘痛、嘈杂、胆瘅、呕苦、胃痞等范畴。导师姜树民教授根据自己多年的科研及临床经验辨证论治总结出了中医治疗BGR的方法,疗效颇佳。