埃索美拉唑联合莫沙比利治疗反流性食管炎临床观察

目的探讨埃索美拉唑联合莫沙比利治疗反流性食管炎（RE）的临床疗效。方法选取2008年至2010年新野卫生职业中专附属医院治疗的86例RE患者,将其随机分成两组：治疗组和对照组各43例,治疗组用埃索美拉唑＋莫沙比利治疗,对照组采用奥美拉唑＋多潘立酮治疗,4周后观察两组的临床症状改善率,并评价内镜下有效率。结果 4周后,治疗组临床总有效率为为93.02%,内镜下总有效率90.70%;对照组临床总有效率为72.09%,内镜下总有效率为69.77%;两组比较差异有统计学意义（P〈0.05）。结论埃索美拉唑联合莫沙比利治疗RE效果良好,值得推广。     

埃索美拉唑联合莫沙必利治疗胃食管反流病的疗效观察

目的观察埃索美拉唑联合莫沙必利治疗胃食管反流病(gastro-esophageal reflux disease,GERD)的疗效。方法将符合GERD诊断标准的86例患者按就诊先后顺序分为治疗组(42例)和对照组(44例),治疗组给予埃索美拉唑(20 mg,每日2次)联合枸橼酸莫沙必利(5 mg,每日3次)治疗,对照组仅给予埃索美拉唑20 mg,每日2次,两组疗程均为8周。观察临床症状的缓解情况和胃镜下食管炎的愈合情况。结果治疗组临床症状改善情况及胃镜检查食管炎的愈合情况明显优于对照组(P<0.05)。结论埃索美拉唑联合莫沙必利治疗GERD疗效优于单用埃索美拉唑。     

埃索美拉唑联合莫沙比利治疗胃食管反流性咳嗽临床观察

目的:评价埃索美拉唑联合莫沙比利治疗胃食管反流性咳嗽的疗效。方法:42例胃食管反流性咳嗽患者随机分为2组,A组23例,给予埃索美拉唑20 mg/次,2次/d,口服;B组19例,给予埃索美拉唑20 mg/次,2次/d,联合莫沙比利5 mg/次,3次/d,口服。8周后按反流性疾病诊断问卷评分标准的模式对咳嗽、烧心、反酸、胸骨后疼痛进行症状评分,比较治疗前、后2组症状改善率及食管炎治愈率。结果:2组治疗后临床症状评分均较治疗前降低(P<0.05),2组治疗后临床症状评分比较差异无统计学意义(P>0.05),但烧心及反酸症状改善B组优于A组(P<0.05);食管炎疗效B组优于A组(P<0.05)。结论:埃索美拉唑可以改善胃食管反流性咳嗽患者的临床症状,联合莫沙比利治疗对临床症状的缓解优于单独应用埃索美拉唑治疗。     

埃索美拉唑在胃食管反流病治疗中的应用

胃食管反流病(gastroesophageal reflux disease，GERD)是指由于胃十二指肠内容物反流至食管引起的烧心等反流症状及(或)造成的食管黏膜组织损害。近年的研究已经证明胃食管反流与部分反复发作的哮喘、咳嗽、夜间睡眠呼吸暂停、非心源性胸痛及咽喉炎等疾病有关。     

埃索美拉唑与莫沙必利联用治疗胃食管反流病疗效观察

目的探讨埃索美拉唑与莫沙必利联用治疗胃食管反流病(GERD)的疗效。方法 80例GERD患者,采用随机双盲法分成2组,治疗组40例,给予埃索美拉唑40 mg/d,莫沙必利5 mg,3次/d,口服。对照组40例,给予埃索美拉唑40mg/d,口服,于治疗后6周观察胃烧心、反流、反酸、非心源性胸痛等症状的缓解情况,并于6周后复查胃镜,观察食管炎治愈率,总有效率。结果治疗组治疗6周后总有效率95%,对照组治疗6周后总有效率80%,2组比较有极显著性差异(P<0.01);治疗组治疗6周后内镜下A、B、C、D级食管炎治愈率达70%,总有效率90%,对照组治疗6周后内镜下A、B、C、D级食管炎治愈率57.5%,总有效率75%,2组比较有极显著性差异(P<0.01)。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。     

埃索美拉唑治疗胃食管反流病重叠功能性消化不良的疗效观察

将我院收治的90例患有胃食管反流病重叠功能性消化不良疾病的患者随机分为对照组和治疗组各45例。对照组采用多潘立酮治疗;治疗组采用多潘立酮与埃索美拉唑联合治疗。治疗组治疗效果明显优于对照组;消化功能恢复正常时间和用药治疗总时间明显短于对照组;未观察到任何药物不良反应。应用埃索美拉唑对患有胃食管反流病重叠功能性消化不良疾病的患者实施治疗的临床效果非常明显。     

多潘立酮及埃索美拉唑联合应用对胃食管反流病的疗效观察

目的探究多潘立酮及埃索美拉唑联合应用对胃食管反流病的疗效观察。方法选取2017年3月～2018年3月我院收治胃食管反流病患者72例,随机分为观察组与对照组各36例。对照组采用奥美拉唑+多潘立酮治疗,观察组采用埃索美拉唑+多潘立酮治疗。对比两组的复发率、治疗总有效率、患者症状改善时间、住院时间。结果对照组复发率36.11%,高于观察组的13.89%,差异有统计学意义(P0.05);观察组患者的住院时间、临床症状消失时间均明显较对照组短,差异有统计学意义(P0.05);对照组治疗总有效率75.00%低于观察组的94.44%,差异有统计学意义(P0.05);两组患者均未出现不良反应。结论对胃食管反流病患者采用多潘立酮及埃索美拉唑联合治疗的临床疗效显著,可有效缓解患者临床症状,改善患者生活质量,促进患者尽早康复。     

埃索美拉唑与雷贝拉唑治疗胃食管反流病的临床疗效比较

目的对比埃索美拉唑与雷贝拉唑缓解胃食管反流病(gastroesophageal reflux disease,GERD)症状和促进镜下食管黏膜愈合的疗效。方法我院确诊的GERD患者217例,按奇偶数原则分为埃索美拉唑组(A组)109例和雷贝拉唑组(B组)108例,分别给予口服埃索美拉唑40 mg qd和雷贝拉唑20 mg qd,按照胃食管反流量表和胃镜检查评估症状缓解和内镜下黏膜愈合情况,并记录睡前加用法莫替丁情况。结果经过8周标准治疗后,两组有效率和总有效率差异无统计学意义(P>0.05),显效率、无效率和睡前加用法莫替丁率差异有统计学意义(P<0.05),内镜下反流性食管炎(RE)黏膜愈合的治愈率、有效率和无效率差异有统计学意义(P<0.05)。结论埃索美拉唑与雷贝拉唑均可有效地治疗GERD,缓解GERD症状,促进RE食管黏膜愈合,但埃索美拉唑促进黏膜愈合情况优于雷贝拉唑,雷贝拉唑治疗夜间酸突破(NAB)优于埃索美拉唑,应根据GERD的不同症状和表现选取第二代PPI制剂。     

埃索美拉唑联合枸橼酸莫沙必利治疗老年胃食管反流病36例

目的:观察埃索美拉唑联合枸橼酸莫沙必利治疗老年胃食管反流病的疗效和不良反应.方法:66例老年胃食管反流病患者按就诊的先后顺序分为观察组(n=36)和对照组(n=30),观察组给予埃索美拉唑(40mg,每天1次)联合枸橼酸莫沙必利(5 mg,每天3次)治疗,疗程4周,对照组按上法单纯给予埃索美拉唑治疗.比较两组的疗效及不良反应发生率.结果:观察组的总有效率为86.1%,对照组为70.0%,两组的疗效构成差异有统计学意义(P=0.042).不良反应方面,尽管两组患者的不良反应总体构成无统计学差异(P=0.077),但分布各有差异.观察组患者的不良反应主要集中在腹泻(19.4%)、口干(16.7%)和便秘(13.9%),而对照组的不良反应分别为便秘(40.0%)、恶心呕吐(20.0%)、口干及头晕/头痛(16.7%),以上不良反应均较轻微,经相应处理可缓解.结论:埃索美拉唑联合枸橼酸莫沙必利治疗老年胃食管反流病的疗效优于单用埃索美拉唑,且安全性较理想,值得在临床上推广应用.     

质子泵抑制剂联合莫沙比利治疗胃食管反流病的临床疗效观察

探讨质子泵抑制剂联合莫沙比利治疗胃食管反流病的临床疗效,为临床治疗提供参考依据。选取收治的100例胃食管反流病患者为研究对象,依随机平均分配原则将其分为观察组和对照组组各50例,对照组单行质子泵抑制剂治疗,观察组于对照组基础上再给予莫沙比利治疗,比较两组临床治疗效果和不良反应发生情况。观察组总有效率为98%,对照组为90%,差异明显,具有统计学意义(P0.05);观察组不良发生率为4%,对照组为6%,差异较小,不具有统计学意义(P0.05)。质子泵抑制剂联合莫沙比利治疗胃食管反流病的临床效果较佳,值得临床推广。     

延续护理对胃食管反流病患者的影响

目的：探讨延续护理对胃食管反流病（ GERD）患者的影响。方法将100例GERD患者随机分为干预组和对照组,每组各50例,两组在住院期间均接受常规护理和出院指导,患者出院后,对照组采用传统门诊随访模式,干预组将延续护理干预贯穿出院后家庭护理全过程。实施前及6个月后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、遵医依从性调查问卷、反流性疾病问卷（RDQ）进行调查,比较干预效果。结果干预前两组患者SAS、SDS、RDQ总分、疾病知识掌握情况、遵医依从性得分比较差异均无统计学意义（P＞0．05）;干预6个月后,干预组RDQ评分为（6．82±2．16）分,SAS为（36．85±6．81）分,SDS为（43．33±7．12）分,均低于对照组,差异有统计学意义（t值分别为9．24,-5．86,-4．62;P＜0．01）;干预后两组患者SAS、SDS评分及RDQ总分均低于干预前,干预前后组内比较差异均有统计学意义（P＜0．05）;干预组疾病知识掌握情况得分为（8．73±0．28）分、遵医依从性为（25．53±1．28）分,均高于对照组,差异有统计学意义（t值分别为11．24,5．62;P＜0．01）。结论对GERD患者实施延续护理干预,提高患者的防治知识,可促进患者的自我管理能力和健康行为,提高患者的遵医依从性,能巩固和提升治疗效果。     

The course of gastroesophageal reflux disease in elderly patients with concomitant ischemic heart disease

AIM: To study basic functional and pathogenetic features of the course of gastroesophageal reflux disease (GERD) in elderly patients with concomitant coronary heart disease (CHD). MATERIAL AND METHODS: Esophagogastroduodenoscopy, 24-h pH-metry, simultaneous 24-h pH- and ECG-monitoring, omeprasol test were made in 126 patients: 74 GERD patients with CHD and 52 patients with GERD alone. RESULTS: Mean number of refluxes for 24 hours in isolated GERD was maximal at stages IIa and IIb (74%). In CHD patients (77%) there was a trend to a rise in this number. Only patients with associated CHD demonstrated a clinically significant depression of ST segment related to reflux, a significantly more frequent occurrence of supraventricular and ventricular extrasystoles. CONCLUSION: The acid component of gastric content pushed into the esophagus is not a leading factor of esophageal mucosa lesion in GERD patients with CHD. Pathological gastroesophageal refluxes may trigger mechanisms provoking new attacks of angina pectoris.     

埃索美拉唑联合马来酸曲美布汀治疗非糜烂性反流病的临床观察

目的 探讨埃索美拉唑联合马来酸曲美布汀治疗非糜烂性反流病（NERD）的临床效果及复发情况.方法 将125例NERD患者应用计算机随机分为治疗组和对照组.治疗组62例,给予埃索美拉唑20 mg,每日2次口服;马来酸曲美布汀0.2g,每日3次口服.对照组63例,给予埃索美拉唑20mg,每日2次口服;枸橼酸莫沙必利5 mg,每日3次口服.疗程均为8周,并于停药后半年进行随访,比较两组临床疗效及复发情况.结果 治疗4周治疗组症状评价总有效率为75.8％ （47/62）,高于对照组的57.1％ （36/63）,差异有统计学意义（x2=4.879,P=0.027）;治疗8周治疗组症状评价总有效率为95.2％ （59/62）,高于对照组的84.1％ （53/63）,差异有统计学意义（x2=4.083,P=0.043）.治疗4周治疗组GERDQ评分有效率为72.6％ （45/62）,高于对照组的52.4％（33/63）,差异有统计学意义（x2=5.434,P=0.020）;治疗8周治疗组GERDQ评分有效为93.5％（58/62）,高于对照组的79.4％（50/63）,差异有统计学意义（x2=5.350,P=0.021）.停药半年后治疗组复发率为77.4％ （48/62）,对照组复发率为81.0％ （51/63）,差异无统计学意义（P =0.627）.结论 埃索美拉唑与马来酸曲美布汀联合治疗NERD安全有效.     

胃食管反流病病人疾病负担研究进展

综述了疾病负担概念及胃食管反流病病人疾病负担现状和相关测量工具,提出国内胃食管反流病病人疾病负担研究的发展趋势。     

Anxious depressive conditions in patients with gastroesophageal reflux disease

The authors objectively evaluated the presence of anxious depressive conditions in patients with gastroesophageal reflux disease (GERD) and studied associations between them and the clinical picture of the disease. Ninety-one patients with GERD were examined. The diagnosis was based on clinical and anamnestic data as well as the results of esophagogastroduodenoscopy and rabeprazole test. Gastrointestinal Symptom Rating Scale (GSRS) was used to assess the severity of GERD symptoms and quality of life. Beck Scale was applied to assess the level of depression. Spielberg test was used to assess reactive and personal anxiety. The psychological status of GERD patients was studied before the beginning of the treatment. Tests and questionnaires were filled by patients on their own. Spielberg test and Beck Scale revealed a high prevalence of psychopathic syndromes among GERD patients. Forty-three per cent of patients had anxious syndrome, while 57% of patients suffered from anxious depressive syndrome; the anxiety level and depression level were clinically significant in 70% of cases and in 23%, respectively. The presence of a direct correlation between the severity of the psychopathological syndromes (according to Spielberg test and Beck Scale) and GSRS data demonstrate that anxiety and depression intensify GERD symptoms and lower the quality of life of these patients. There is no doubt that concomitant anxious and anxious-depressive disturbances need psychotherapeutic and drug correction. Tranquilizers have the priority in neurotic anxious disturbances. In some situations antidepressants are indicated to treat a combination of anxious disturbances and depressive ones.     

PDCA循环护理干预在胃食管反流病患者中的应用

目的探讨PDCA循环护理干预在胃食管反流病患者中的应用效果。方法选取胃食管反流患者100例,随机均分为对照组和观察组各50例。对照组患者在住院期间接受常规护理,观察组患者采用PDCA循环护理干预法。比较2组患者护理前后胃食管反流疾病问卷(RDQ)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分。结果 2组患者护理干预后,观察组患者的RDQ、SDS、SAS评分均低于对照组(P0.05)。结论 PDCA循环护理干预在胃食管反流术中应用效果较好,可有效缓解患者的负性情绪,对患者的康复状态有积极的影响。     

Diagnosis and treatment of gastroesophageal reflux disease in the elderly

Gastroesophageal reflux disease poses special diagnostic and therapeutic challenges in the elderly. These patients may not report the classic symptoms of dysphagia, chest pain, and heartburn, and they are more likely to develop severe disease and complications such as esophageal ulceration and bleeding. Therapeutic options include lifestyle changes, medication, and surgery. Polypharmacy and changes in renal, hepatic, and gastrointestinal function can complicate treatment. Proton pump inhibitors can help optimize disease management. The most common primary presenting symptoms of GERD in the elderly are regurgitation, dysphagia, dyspepsia, vomiting, and noncardiac chest pain, rather than heartburn. Because the elderly commonly take multiple drugs for various comorbidities, drug interactions and treatment responses must be carefully assessed in this patient population. Nonpharmacologic measures may be helpful but often do not relieve nighttime GERD symptoms.     

Histopathology of columnar-lined esophagus in patients with gastroesophageal reflux disease

BACKGROUND AND AIMS: The question of whether an endoscopically normal-appearing esophagogastric junction should be biopsied in patients with gastroesophageal reflux disease is controversial. We have addressed this issue using endoscopy and histopathology. METHODS: A total of 114 consecutive patients (58 males) with symptoms of gastroesophageal reflux disease prospectively underwent endoscopy, including biopsy sampling from the esophagogastric junction. Endoscopically visible columnar-lined esophagus was defined by the presence of gastric-type mucosa above the level of the rise of the gastric folds. Histopathology was conducted using the Paull-Chandrasoma classification. RESULTS: Of the 114 patients, 85 (74.6%) had endoscopically visible columnar-lined esophagus of length < or =0.5 cm (n = 82), 1 cm (n = 2) and 7 cm (n = 1); 29 patients (25.4%) had a normal endoscopic junction. All patients had histopathologic columnar-lined esophagus. Intestinal metaplasia and low-grade dysplasia was identified in 26 (22.8%) and 5 (4.4%) individuals, respectively, and was not statistically different in endoscopically normal vs. abnormal junction (P = 0.408 for intestinal metaplasia, P = 0.775 for low grade dysplasia). Intestinal metaplasia was independent from endoscopic esophagitis (P = 0.398) and hiatal hernia (P = 0.405). CONCLUSIONS: Columnar-lined esophagus cannot be excluded by endoscopy. In patients with gastroesophageal reflux disease, biopsy sampling of normal-appearing junction is recommended for histopathologic exclusion of intestinal metaplasia and low-grade dysplasia.