国产兰索拉唑及雷尼替丁合用治疗难治性胃食管反流病

目的 为了观察联合运用国产兰索拉唑及雷尼替丁治疗难治性胃食管反流病（GERD）的疗效。方法 选取难治性GERD20例，清晨服用国产兰索拉唑30mg，夜间睡前服用雷尼替丁300mg，8周为1个疗程。治疗前后均作胃镜，观察反流症状及镜下食管黏膜改变。结果 症状评价，显效13例，有效5例，无效2例，总有效率90％。胃镜下食管改变：显效10例，有效8例，总有效率94．7％。结论 国产兰索拉唑联合雷尼替丁治疗难治性GERD有较好疗效。     

兰索拉唑与法莫替丁联合治疗胃食管反流病

目的观察兰索拉唑联合法莫替丁治疗胃食管反流病的临床疗效。方法将86例胃食管反流病患者随机分为治疗组和对照组,治疗组采用兰索拉唑与法莫替丁联合给药,对照组单用兰索拉唑治疗,均疗程8周后行胃镜检查,观察其反流症状的改善程度。按内镜检查结果、症状积分下降值对比分析疗效。结果治疗后治疗组总有效率为93.02%,对照组总有效率为74.42%,两组总有效率差异有统计学意义(P<0.05)。治疗后两组症状积分比较差异有统计学意义(P<0.05),治疗组患者症状积分下降快且明显。结论兰索拉唑与法莫替丁联合治疗胃食管反流病比单一用兰索拉唑治疗效果好,值得推广使用。     

兰索拉唑联合莫沙必利治疗胃食管反流性疾病

我院自2001年6月至2006年12月采用兰索拉唑联合莫沙必利治疗胃食管反流性疾病（GERD）60例，效果显著，现总结如下。[第一段]     

兰索拉唑联合安中片治疗胃食管反流病的临床观察

胃食管反流病(gastroesophageal reflux disease, GERD)是较常见的消化道疾病,病因较多,确切机制不完全明了,且其发病率高,呈反复发作[1].目前胃食管反流病的药物治疗仍以抑酸和胃肠促动力为主.     

兰索拉唑联合莫沙必利治疗胃食管反流病临床疗效观察

目的探讨兰索拉唑和莫沙必利联合用药对胃食管反流病(GERD)的治疗效果。方法将142例GERD患者随机分为3组,即兰索拉唑联合莫沙必利组、兰索拉唑组和莫沙必利组,疗程均为6周,观察症状改善情况。结果兰索拉唑+莫沙必利组治疗总有效率明显高于兰索拉唑组(82.2%)与莫沙必利组(87.2%),差异有统计学意义(P<0.05)。结论兰索拉唑和莫沙必利联合用药治疗胃食管反流病临床疗效较好。     

兰索拉唑对胃食管反流性疾病的临床疗效

研究证明，胃食管反流性疾病（ＧＥＲＤ）的严重程度与反流物酸度、食管酸暴露的频率和接触时间密切相关，使用强有力的质子泵抑制剂获得的高水平胃酸持续抑制对ＧＥＲＤ很有效，本文就ＧＥＲＤ的流行病学、发病机制以及兰索拉唑的临床疗效等方面作一简要综述。ＧＥＲＤ的...     

兰索拉唑联合莫沙比利治疗59例胃食管反流病的疗效分析

目的观察兰索拉唑治疗胃食管反流病（GERD）的临床疗效。方法随机将59例GERD患者分为2组,治疗组30例,给予兰索拉唑30 mg,口服,每天1次加莫沙比利5 mg,口服,每天3次;对照组29例,给予法莫替丁20 mg,口服,每天2次加莫沙比利5 mg,口服,每天3次;疗程8周。记录服药前后患者烧心、反酸.胸骨后灼痛等症状积分的改变,按症状积分下降值及内镜检查结果对比分析疗效。结果治疗组症状改善与内镜下食管炎治愈率明显高于对照组。结论兰索拉唑是一种治疗胃食管反流病速效且安全的质子泵抑制剂（PPI）。     

东方胃药联合兰索拉唑治疗胃食管反流病效果观察

目的：研究东方胃药联合兰索拉唑治疗胃食管反流病的效果及对食管动力学、脑-肠轴的影响。方法：以2020年5月至2022年11月收治的116例胃食管反流病患者为研究对象,采用随机数字表法分为常规组和观察组各58例。常规组采用兰索拉唑治疗,观察组采用东方胃药联合兰索拉唑治疗。比较两组临床疗效、治疗前和治疗4周后中医证候积分（反酸、烧心、胸膈痞满、嗳气）、食管动力学指标（食管括约肌压力、蠕动收缩比、食管括约肌松弛率）、血清脑-肠轴相关因子[胃泌素（GAS）、胃动素（MTL）、血管活性肠肽（VIP）、5-羟色胺（5-HT）]水平、血清致炎因子[超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]水平。结果：治疗4周后,观察组临床总有效率为94.83%,高于常规组的82.76%（P＜0.05）;观察组反酸、烧心、胸膈痞满、嗳气等评分低于常规组（P＜0.05）;观察组食管括约肌压力、蠕动收缩比、食管括约肌松弛率高于常规组（P＜0.05）;观察组血清GAS、MTL、5-HT水平高于常规组,VIP水平低于常规组（P＜0.05）;观察组血清hs-CRP、IL-6、TNF-α水平低于常规组（P＜0.05）。结论：东方胃药联合兰索拉唑治疗胃食管反流病患者疗效显著,可有效改善临床症状,调节食管动力学指标及血清脑-肠轴相关因子水平,缓解炎症反应。     

兰索拉唑联合六味安消治疗胃食管反流疗效观察

目的:探讨兰索拉唑联合六味安消治疗胃食管反流的临床效果。方法:52例胃食管反流患者随机分为治疗组27例和对照组25例,治疗组给予六味安消3粒,每天3次。兰索拉唑15mg,每日2次;对照组给予兰索拉唑15mg,每天2次。疗程均为4w。结果:治疗组显效率66.7%,总有效率为92.6%;对照组显效率36.0%,总有效率为84.0%。两组比较差异有统计学意义(P<0.05)。结论:兰索拉唑联合六味安消治疗对胃食管反流疾病效果明显。     

Surgical treatment for GERD

Surgical treatment for GERD is still indicated in a few cases. In particular, patients who resist PPI medical treatment, patients who do not comply well with medication, and young patients with strong subjective symptoms are candidates for surgical treatment. Others include patients with free reflux, with short esophagus, with esophageal stenosis, and with respiratory or oto-laryngological complications. The choice of operative method depends on the disease state and stage of GERD. The first choice of treatment in most cases is laparoscopic Nissen technique, and the second choice is laparoscopic Toupet method. The problem for surgeons is the need for extremely delicate technique in the reconstructive parts of the procedure in cases with a high degree of fundoplication and functional disorder. We adopted an operative technique that combines SPV, Toupet method and Hill method; we have found a good rate of patient acclimatization and high postoperative satisfaction. Time is still required, however, to bring laparoscopic surgery to the same level as open surgery.     

Pharmacokinetic-pharmacodynamic study of oral lansoprazole in children

OBJECTIVE: We investigated the pharmacokinetics, pharmacodynamics, and tolerability of lansoprazole in children after single and multiple administrations. METHODS: Forty children (age range, 18 days-14 years) with gastric acid-related disorders entered an open study and received lansoprazole in a single dose of 17 mg. m(-2) (group A) or in multiple doses (17 mg. m(-2) per day) for 7 to 14 days (group B). Lansoprazole plasma concentrations were measured by HPLC. A 24-hour intragastric pH monitoring assessed the antisecretory effect. RESULTS: In group A, maximal concentration (C(max)) was 1023 +/- 775 (mg. L(-1))/(17 mg. m(-2)), time to reach C(max) was 1.8 +/- 0.8 hours, elimination half-life was 1.5 +/- 2.0 hours, area under the concentration-time curve from time zero to infinity [AUC(0-infinity)] was 3503 +/- 6025 (mg. L(-1). h)/(17 mg. m(-2)), apparent plasma clearance was 0.57 +/- 0.47 L. h(-1). kg(-1), and apparent volume of distribution was 0.61 +/- 0.36 L. kg(-1). In group B, C(max) was 750 +/- 511 (mg. L(-1))/(17 mg. m(-2)), time to reach C(max) was 1.8 +/- 1.1 hours, elimination half-life was 1.2 +/- 1.1 hours, AUC(0-infinity) was 2351 +/- 3691 (mg. L(-1). h)/(17 mg. m(-2)), apparent plasma clearance was 0.71 +/- 0.50 L. h(-1). kg(-1), and apparent volume of distribution was 0.9 +/- 0.7 L. kg(-1). No influence of age was shown on pharmacokinetic parameters in both groups. However, data suggested that elimination was reduced in neonates and higher in infants than in adults. The values for 24-hour percentage of time at gastric pH <4 and pH <3 were 61% +/- 21% and 51% +/- 21% (group A) and 47% +/- 24% and 37% +/- 21% (group B), respectively. In both groups the antisecretory effect decreased with age, and in group A it was positively correlated to C(max) and AUC(0-infinity). The mean gastrin serum concentration significantly increased (+31%) after 12.6 +/- 1.5 days of treatment. CONCLUSIONS: Lansoprazole was well tolerated in children. After a single oral dose of 30 mg per 1.73 m(2), there was a trend for the elimination to be higher in infants than in adults and the antisecretory effect appeared to be higher in infants younger than 6 months than in older children and adults.     

A review of the clinical and economic impact of using esomeprazole or lansoprazole for the treatment of erosive esophagitis

BACKGROUND: The use of proton pump inhibitors (PPIs) for the treatment of erosive esophagitis has had a major impact on the prescribing budgets of primary care organizations in the United Kingdom. Assessments of the clinical and economic effectiveness of PPIs would provide useful tools for decision-making. OBJECTIVE: The goal of this study was to review the available preclinical and clinical studies comparing esomeprazole with lansoprazole in the healing and maintenance of erosive esophagitis, and to compare the budgeting impact of the 2 strategies. Comparative tolerability was also reviewed. METHODS: MEDLINE (1966-September 2002) and EMBASE (1980-September 2002) were searched for abstracts and articles reporting comparative studies of esomeprazole and lansoprazole. The search terms used were gastroesophageal reflux disease, reflux esophagitis, and proton pump inhibitor; all comparisons of esomeprazole and lansoprazole at any dose were considered. The database search was supplemented based on the authors' familiarity with the literature. RESULTS: The comparative studies that were identified fell into 4 categories: (1) intragastric acid suppression studies; (2) randomized controlled trials in the healing of erosive esophagitis; (3) randomized controlled trials in the maintenance of erosive esophagitis; and (4) health economic analyses. Based on these studies, when healing doses (esomeprazole 40 mg once daily, lansoprazole 30 mg once daily) and low doses (20 and 15 mg once daily, respectively) were compared, esomeprazole was more efficacious than lansoprazole in suppressing acid in the intragastric compartment (both comparisons, P < 0.05). More patients with erosive esophagitis experienced healing at 4 and 8 weeks with esomeprazole 40 mg once daily than with lansoprazole 30 mg once daily (P < 0.001 at 4 and 8 weeks). At 6 months, remission was maintained in more patients receiving esomeprazole 20 mg once daily than in those receiving lansoprazole 15 mg once daily (P < 0.001). No significant differences in tolerability were noted in clinical trials that directly compared the 2 PPIs. When the cost-effectiveness of esomeprazole treatment was compared with that of lansoprazole treatment in the healing and maintenance of erosive esophagitis, the greater efficacy of esomeprazole translated into potential cost savings and better outcomes. CONCLUSION: The currently available comparative data for esomeprazole and lansoprazole indicate clinical and cost-effectiveness advantages for esomeprazole in the healing and maintenance of erosive esophagitis compared with lansoprazole.     

The Stretta procedure for the treatment of gastro esophageal reflux disease (GERD)

Summary

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the gastrointestinal tract. Laparoscopic anti-reflux surgery has been shown to be safe and effective for the treatment of GERD with excellent symptom control. However, an approach to the treatment of GERD that has less morbidity than surgery and obviates the need for drugs is desirable. The endoscopic delivery of temperaturecontrolled radiofrequency energy (RF) to the gastroesophageal junction (GE), termed Stretta (Curon Medical, Sunnyvale, CA, USA), has recently been shown to be safe, well tolerated, and highly effective in patients with GERD. We review the basic principles, technique, potential mechanisms of action, and effectiveness of the Stretta procedure.     

Double-blind controlled-clinical trials of lansoprazole in the treatment of peptic ulcer]

Two multicentre clinical trials of lansoprazole, a new proton pump inhibitor, were completed in patients with gastric and duodenal ulcer. Double-blind comparative studies with a beta-blocker, famotidine, in gastric ulcer (study 1) and in duodenal ulcer (study 2) were conducted. Study 1. A total of 316 cases of gastric ulcer, 158 for lansoprazole, 158 for famotidine were treated for eight weeks and the bollowing observed. Healing rates by endoscopic findings were 90% for lansoprazole and 72% for famotidine respectively, with a significant difference (p less than 0.01). Adverse events were observed in five cases in lansoprazole group, six cases in the famotidine group. Study 2. A total of 291 cases of duodenal ulcer, 148 for lansoprazole, 143 for famotidine, were treated for six weeks. Healing rates by endoscopic fendings were 92% for lansoprazole and 85% for famotidine respectively. Adverse effects were observed in 5.3% in the lansoprazole group, and 5.5% in the famotidine group.     

埃索美拉唑治疗支气管哮喘合并胃食管返流临床疗效观察

目的 观察埃索美拉唑治疗支气管哮喘合并胃食管返流(GERD)临床疗效.方法 选自2009年7月至2011年7月收治的58例支气管哮喘合并GERD患者,根据治疗药物的不同分为两组,其中治疗组30例,采用埃索美拉唑联合莫沙比利治疗,对照组28例,采用奥美拉唑联合莫沙比利治疗.观察比较两组治疗前后的支气管哮喘评分和胃食管返流症状评分.结果 两组治疗后支气管哮喘评分和胃食管返流症状评分,与治疗前比较,差异均有统计学意义(P＜0.01);治疗后,治疗组支气管哮喘评分和胃食管返流症状评分降低较对照组更为明显,两组比较差异均有统计学意义(P＜0.01).结论 埃索美拉唑是治疗支气管哮喘合并GERD安全有效的药物.     

Lifestyle modification as a medical treatment for GERD

Lifestyles such as obesity, smoking, alcohol or fatty meal are long-time considered to related with the deterioration of GERD. Basic studies indicate that smoking and alcohol decrease LES pressure. However, the clinical studies of the relationship between lifestyle and GERD sometimes show coflicting results. Lifestyle modification as a medical treatment of GERD were reviewed.     

Influence of lansoprazole treatment on diazepam plasma concentrations.

The possible influence of long-term treatment with lansoprazole on the single-dose pharmacokinetics of diazepam was investigated in 12 healthy male volunteers. In this double-blind randomized crossover study, 60 mg lansoprazole or placebo was administered once daily for 10 days. One hour after administration on day 7, 0.1 mg/kg diazepam was administered intravenously, and blood was collected up to 96 hours after the injection for plasma diazepam and desmethyldiazepam measurement. During the placebo session, the plasma elimination half-life, clearance, and volume of distribution of diazepam were 26.0 +/- 1.6 hours, 22.5 +/- 1.1 ml/hr/kg, and 0.82 +/- 0.04 L/kg, respectively. These parameters were not significantly different during the lansoprazole session. The mean plasma concentrations of desmethyldiazepam were similar in both sessions. These findings illustrate that long-term treatment with a therapeutic dose of lansoprazole does not interfere with the metabolism of diazepam.