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1.
雷贝拉唑治疗胃食管反流病的疗效观察   总被引:1,自引:0,他引:1  
目的 评价雷贝拉唑治疗胃食管反流病的疗效.方法 将2007年3月至2009年9月在江苏省灌南县中医院消化内科门诊就诊的并经胃镜检查的胃食管反流病患者290例随机分为两组,口服雷贝拉唑148例(观察组),口服奥美拉唑和多潘立酮142例(对照组).疗程均为4周.观察两组患者临床症状烧心,反流等改善程度,复查胃镜观察糜烂的食管黏膜修复情况.结果 两组治疗前后烧心,反流等症状评分下降差异有统计学意义(P<0.01),说明两组方法治疗GERD均有明显疗效.两组疗效比较差异无统计学意义.结论 小剂量雷贝拉唑治疗GERD疗效肯定,与奥美拉唑和多潘立酮联合用药效果相近,而且用药不良反应少,可作为治疗GERD的首选用药.  相似文献   

2.
目的观察雷贝拉唑联合针灸治疗非糜烂反流性食管病的疗效。方法将68例患者随机分为观察组(34例)和对照组(34例)。观察组:雷贝拉唑10mg,每日1次,联合针灸治疗;对照组:雷贝拉唑10mg,每日2次。于治疗后4周评价烧心、反酸、胸痛等症状疗效。结果观察组临床有效率94.1%,对照组临床有效率58.8%,两组比较差异有显著性。结论雷贝拉唑联合针灸治疗非糜烂性反流病比雷贝拉唑加倍剂量组具有更好的疗效。  相似文献   

3.
目的 观察雷贝拉唑、铝碳酸镁及两药联合对胆囊切除后伴有胆汁反流的胃炎的疗效.方法 胆囊切除后,经24 h胃内胆红索监测证实伴有胆汁反流的胃炎患者随机分为4组:空白对照组(n=30)、雷贝拉唑组(n=30,雷贝拉唑20 mg,1次/d)、铝碳酸镁组(n=29,铝碳酸镁1.0 g,3次/d)及联合用药组(n=31,雷贝拉唑+铝碳酸镁,用法同上),疗程8周.观察各组患者腹痛、腹胀、烧心、口苦等症状改善情况,并于治疗结束后2周复查胃镜及组织学检查并再次进行24 h胃内胆红素监测,进行胃镜下黏膜炎性反应程度(充血、水肿),组织学炎性反应程度(炎性反应、活动性)量化评分以及24 h胆红索吸收值(ABS)>0.14总时间百分比、十二指肠内容物反流次数、长反流次数(>5 min)的变化比较.结果 治疗后三组治疗组患者症状均有所改善,联合用药组内镜下水肿程度(2.11±0.77比1.50±0.67,P<0.05)及HE染色组织学活动性评分(2.87±0.72比1.97±0.78,P<0.05)均明显改善,长时间十二指肠内容物反流次数明显减少(18.26±1.80比9.70±1.20,P<0.05),雷贝拉唑组和铝碳酸镁组上述指标治疗前后差异无统计学意义;三组治疗组患者ABS>0.14的时间治疗前后差异均有统计学意义(P<0.05).结论 雷贝拉唑和铝碳酸镁联用可有效治疗伴有胆汁反流的胃炎.  相似文献   

4.
雷贝拉唑试验对胃食管反流病的诊断价值   总被引:4,自引:0,他引:4  
目的 :探讨质子泵抑制剂雷贝拉唑试验对胃食管反流病 (GERD)的诊断价值。方法 :根据临床反流症状、食管 2 4hpH监测以及胃镜检查结果 ,将 93例有反流症状的病人 (78例GERD病人和 1 5例非GERD病人 )随机分为试验组 (雷贝拉唑组 ,45例 )和对照组(安慰剂组 ,48例 )。试验组用雷贝拉唑 2 0mg/d ;对照组用维生素B1 口服 ,2 0mg/d。两组均用药 2周 ,记录服药前后病人烧心、反酸、胸骨后灼痛症状积分的改变 ,按症状积分下降值判定诊断 ,与食管 2 4hpH监测以及胃镜检查结果对比分析。结果 :试验组的GERD病人服药后 5d、7d、2周症状积分下降值分别为 5 .4± 3 .7、7.1± 5 .3、9.8± 6.4,下降率分别为 34.7%、46 .3%、62 .6 %。以症状下降 3分为标准 ,雷贝拉唑试验诊断GERD的价值最佳 ,对服药时间分析 ,则以服雷贝拉唑 5d为佳。结论 :雷贝拉唑治疗试验是GERD临床诊断的一种简单、可靠的方法  相似文献   

5.
目的探讨右旋雷贝拉唑钠对反流性食管炎模型大鼠炎性因子及血管活性肠肽(vasoactive intestinal peptide,VIP)的影响。方法选择60只SPF级大鼠为研究对象,随机分为空白对照组、模型组、雷贝拉唑钠组(4 mg/kg)、小剂量右旋雷贝拉唑钠组(2 mg/kg)和大剂量右旋雷贝拉唑钠组(4 mg/kg),空白组不作任何处理,其余4组建立大鼠反流性食管炎模型,观察各组大鼠食管炎指数、食管炎抑制率、炎性因子及VIP表达水平。结果大剂量右旋雷贝拉唑钠组食管炎指数明显低于雷贝拉唑钠组,抑制率明显高于雷贝拉唑钠组(t=3.725,7.595,P0.05),一氧化氮(NO)、白细胞介素-6(IL-6)水平均明显低于雷贝拉唑钠组(t=2.054,6.386,P0.05),VIP明显低于雷贝拉唑钠组,P物质(SP)明显高于雷贝拉唑钠组(t=2.826,3.162,P0.05);小剂量右旋雷贝拉唑钠与雷贝拉唑钠食管炎指数等差异均无统计学意义(P0.05)。结论右旋雷贝拉唑钠有通过降低炎性因子及VIP的表达,提高兴奋性多肽类神经递质的表达来发挥治疗反流性食管炎的作用,相同剂量条件下,右旋雷贝拉唑钠作用效果强于雷贝拉唑钠。  相似文献   

6.
雷贝拉唑治疗难治性胃食管反流病的临床研究   总被引:4,自引:0,他引:4  
目的探讨雷贝拉唑治疗难治性胃食管反流病(rGERD)的临床疗效。方法48例经第一代质子泵抑制剂(PPI)治疗4周无效的GERD,随机分成两组。观察组24例口服雷贝拉唑10mg,每日2次,加西沙比利10mg,每日3次;对照组口服雷贝拉唑10mg,每日2次。治疗4周及8周后复查内镜,并评价临床症状。结果治疗4周后两组症状评分均较治疗前显著下降(P<0.05),但内镜下分级改善情况比较差异无显著性(P<0.05)。治疗8周后两组在症状评分和内镜分级均较治疗前显著改善(P<0.05)。雷贝拉唑+西沙比利组4周后有效率87.5%,显著高于单用雷贝拉唑组58.3%(P<0.05);8周后两组有效率分别为95.8%和83.3%,两者比较差异无显著性(P>0.05)。结论加倍剂量的雷贝拉唑治疗难治性GERD快速、有效,且其长期疗效不依赖西沙比利,联合西沙比利有利于提高雷贝拉唑的早期疗效。  相似文献   

7.
雷贝拉唑、莫沙比利治疗胃食管反流病的临床疗效观察   总被引:4,自引:0,他引:4  
目的探讨雷贝拉唑(江苏豪森医药集团)、莫沙比利治疗胃食管反流病的临床疗效。方法将124例确诊为反流性食管炎的患者随机分为2组,治疗组(62例)给予雷贝拉唑(10mg,2次/d)联合莫沙比利(5mg,3次/d)治疗;对照组(62例)给予奥美拉唑(阿斯利康有限公司)20mg,2次/d联合多潘立酮(10mg,3次/d)治疗,观察其临床疗效。结果治疗组和对照组分别在症状和胃镜下疗效方面差异有统计学意义(P0.05)。结论雷贝拉唑联合莫沙比例治疗胃食管反流病优于奥美拉唑联合多潘立酮。  相似文献   

8.
目的 了解联合食管多通道腔内阻抗pH(MII-pH)监测诊断胃食管反流病(GERD)的价值.方法 纳入具有烧心症状且食管黏膜无损伤患者44例,首先行MII-pH监测,然后行14 d的雷贝拉唑试验(试验结束时烧心症状完全消失定义为雷贝拉唑试验阳性).70名健康志愿者行MII-pH监测的结果作为正常值进行参照.结果 根据食管pH监测存在异常食管酸暴露或酸反流症状指数(SI)阳性者20例(45.4%).MII-pH监测提示弱酸反流SI阳性者2例,据此检查诊断烧心患者GERD的比例增至50%(22/44).雷贝拉唑试验阳性4例,据此则将烧心患者诊断为GERD的比例增至54.5%(24/44).结论 联合食管MII-pH监测可增加GERD检出率.  相似文献   

9.
目的 了解联合食管多通道腔内阻抗pH(MII-pH)监测诊断胃食管反流病(GERD)的价值.方法 纳入具有烧心症状且食管黏膜无损伤患者44例,首先行MII-pH监测,然后行14 d的雷贝拉唑试验(试验结束时烧心症状完全消失定义为雷贝拉唑试验阳性).70名健康志愿者行MII-pH监测的结果作为正常值进行参照.结果 根据食管pH监测存在异常食管酸暴露或酸反流症状指数(SI)阳性者20例(45.4%).MII-pH监测提示弱酸反流SI阳性者2例,据此检查诊断烧心患者GERD的比例增至50%(22/44).雷贝拉唑试验阳性4例,据此则将烧心患者诊断为GERD的比例增至54.5%(24/44).结论 联合食管MII-pH监测可增加GERD检出率.  相似文献   

10.
《内科》2015,(5)
目的探讨奥美拉唑联合多潘立酮治疗哮喘合并胃食管反流(GERD)的临床疗效。方法选取哮喘合并胃食管反流患者72例,随机分为观察组和对照组,每组36例。观察组患者给予奥美拉唑联合多潘立酮治疗,对照组患者仅给予奥美拉唑治疗。比较两组患者哮喘、胃食管反流症状改善情况;两组患者治疗前后胃食管反流症状评分和肺功能状况。结果观察组患者哮喘症状治疗总有效率(97.22%)显著高于对照组患者(80.56%),差异具有统计学意义(P0.05);观察组患者哮喘症状的改善显著优于对照组患者(P0.05)。两组患者治疗后胃食管反流症状均显著改善(P0.05);观察组患者的胃食管反流症状改善优于对照组患者(P0.05)。两组患者治疗后GERD评分、FEV1、PEF、PEF均显著改善(P0.05),观察组患者GERD症状评分和肺功能(FEV1、PEF)均优于对照组患者(P0.05)。结论奥美拉唑联合多潘立酮治疗哮喘合并胃食管反流患者可显著改善哮喘临床症状以及胃食管反流症状,改善患者肺功能,安全可靠,值得推广应用。  相似文献   

11.
BACKGROUND/AIMS: This study was done to evaluate the efficacy of rabeprazole (proton-pump-inhibitor) and ranitidine (H(2)-receptor antagonist) in the symptom relief and treatment of erosive esophagitis diagnosed by endoscopy. METHODS: A total of 110 patients with typical gastroesophageal reflux disease (GERD) symptoms were enrolled in this multicenter study. They were randomized into rabeprazole group (53 patients) and ranitidine group (57 patients) respectively. The patients in rabeprazole group were given 10 mg of rabeprazole and ranitidine group received 300 mg of ranitidine before breakfast and dinner for 8 weeks. After the end of treatment, we evaluated the endoscopic healing rate of reflux esophagitis and symptomatic improvement. RESULTS: After 8 weeks of treatment, rabeprazole group showed significantly higher complete endoscopic cure rate than ranitidine group (86.8% [46/53] vs. 57.9% [33/57], p=0.001) and higher symptomatic improvement of heartburn (91.2% [31/34] vs. 76.2% [32/42], p=0.085), especially in the first 7 days (76.7% vs. 45.3%, p=0.008). Also, rabeprazole group showed significantly higher improvement of regurgitation symptom than ranitidine group (100% [35/35] vs. 83% [39/47], p=0.009). Both group showed no differences in the improvement of chest pain and globus sensation. All the adverse events (rabeprazole group 4 events vs. ranitidine group 3 events) were mild and there was no abnormality in laboratory test. CONCLUSIONS: In patients with GERD, rabeprazole 10 mg b.i.d. is superior to ranitidine 300 mg b.i.d. in healing of reflux esophagitis and resolving typical GERD symptoms. Rabeprazole is an effective and well-tolerated drug for GERD treatment.  相似文献   

12.

Backgrounds

Some non-erosive reflux disease (NERD) and reflux esophagitis (RE) patients are unresponsive to a proton pump inhibitor (PPI) at standard dose. We investigated the predictive marker of the efficacy of PPI for GERD patients including NERD and RE treated with standard and increased doses of a PPI.

Methods

Patients with symptomatic gastroesophageal reflux disease (GERD) (NERD and RE) were treated with rabeprazole (RPZ) 10?mg once daily for 4?weeks. The RPZ dosage was increased to 10?mg twice daily for an additional 2?weeks and again to 20?mg twice daily for another 2?weeks if heartburn was not relieved. Baseline characteristics and efficacy of RPZ were assessed on the basis of a heartburn diary and frequency scale for symptoms of GERD (FSSG).

Results

Complete heartburn relief rates after 4?weeks were 42.5% (31/73) and 67.9% (19/28) in NERD and RE groups, respectively, which rose to 68.9 and 91.7% after dose escalation. Multivariate analysis revealed that parameters associated with resistance to RPZ 10?mg once daily were female, non-smoking, frequent heartburn, low score for question 4 (Q4) of the FSSG (subconsciously rubbing the chest), and high scores for Q3 (heavy stomach after meal) and Q7 (unusual sensation in the throat). Frequent heartburn and a high score for Q7 were associated with resistance to RPZ 20?mg twice daily. FSSG scores of patients resistant to RPZ were significantly higher in comparison with responders before and during treatment.

Conclusions

FSSG could predict response to a PPI for symptomatic GERD. Increase of RPZ dose is useful for treatment of GERD refractory to the standard dose of RPZ.  相似文献   

13.
AIM:TO compare the efficacy and safety of dexrabe-prazole 10 mg versus rabeprazole 20 mg in the treatment of gastroesophageal reflux disease (GERD).
METHODS: This was a randomized, double-blind clinical study. Fifty patients with GERD were randomly assigned to receive dexrabeprazole 10 mg or rabeprazole 20 mg once daily. Efficacy was assessed by evaluating improvement in visual analog scale (VAS) scores of heart-burn and regurgitation and safety was assessed by recording incidence of any adverse drug reactions. Laboratory investigations and upper gastro-intestinal endoscopy was conducted at baseline and after 28 d of therapy.
RESULTS: A total of 50 patients (n = 25 in dexrabeprazole group and rabeprazole group each) completed the study. There were no significant differences in the baseline characteristics between the two groups. The VAS score (mean 4. SD) of heartburn and regurgitation in dexrabeprazole (64.8±5.1 and 64 ± 8.1, respectively) and rabeprazole (64.4 ± 8.7 and 57.6 ± 9.7, respectively) groups significantly reduced (P 〈 0.0001) to 30 ± 11.5, 24 ± 10 and 32 ± 9.5, 29.2±11.9, respectively on d 28. A significantly higher (P = 0.002) proportion of patients showed ≥ 50% improvement in regurgitation with dexrabeprazole 10 mg (96%) compared to rabeprazole 20 mg (60%). Onset of symptom improvement was significantly earlier with dexrabeprazole than with rabeprazole (1.8 ± 0.8 d vs 2.6 ± 1.4 d; P 〈0.05). The incidences of esophagitis in the dexrabeprazole group and rabeprazole group before therapy were 84% and 92%, respectively (P = 0.38). The incidence of improvement/healing of esophagitis after therapy was more (P = 0,036) in the dexrabeprazole group (95.2%) compared to the rabeprazole group (65.2%). No adverse drug reaction was seen in either group.
CONCLUSION: In the treatment of GERD, efficacy of dexrabeprazole 10 mg is better than rabeprazole 20 mg, with regards to improvement/healing of endoscopic lesions and relief fro  相似文献   

14.
胃食管反流病的症状评分及内镜下表现的对照研究   总被引:1,自引:1,他引:1  
目的探讨用胃食管反流病(GERD)的症状评分及内镜下表现的对照研究来预测和评估是否有GERD及其程度。方法对500例有胃食管反流症状的患者按症状频率、病期与程度为评分标准进行症状评分,内镜检查是否有反流性食管炎(RE)并分级。比较症状评分与内镜分级的相关性,分析症状评分对GERD的评估价值。200例无症状体检者作为阴性对照。结果GERD症状评分与RE内镜分级呈正相关(r=0.560,P〈0.01)。RE组患者的症状评分高于非糜烂性反流病(NERD)组,RE组症状评分≥8分者有81.70%,NERD组为59.35%(P〈0.05);RE患者烧心的程度及发作频率、反酸的发作频率与病期重于NERD。GERD组与无反流症状组内镜检查结果比较亦有统计学意义(P〈0.01)。结论症状评分是诊断GERD的一个良好的筛选项目。  相似文献   

15.
The purpose of this study was to assess the rapidity of symptom relief and 4-week efficacy of rabeprazole 20 mg in patients with moderately severe nonerosive gastroesophageal reflux disease. Data were analyzed from 2 similarly designed, double-blind, placebo-controlled, multicenter, U.S. trials. After a 2-week placebo run-in period, patients (N = 261) were randomized to 4 weeks of rabeprazole 20 mg once daily or placebo. Patients kept symptom diaries and scored symptom severity. Median time to first 24-hour heartburn-free interval was 3.5 days for the rabeprazole group compared with 19.5 days for the placebo group (P ≤ .0002). Complete heartburn relief at week 4 was 32% with rabeprazole and 3.8% with placebo (P ≤ .001). Rabeprazole also significantly improved other GERD-associated symptoms (e.g., regurgitation, belching, early satiety) by week 4 compared with placebo (P ≤ .05). Rabeprazole provides fast and potent relief from heartburn and other symptoms of nonerosive gastroesophageal reflux disease. Supported by Eisai Inc., Teaneck, New Jersey, and Janssen Pharmaceutica Inc., Titusville, New Jersey.  相似文献   

16.
OBJECTIVE: The findings of several studies suggest that proton-pump inhibitors (PPIs) suppress gastric acid more effectively in Helicobacter pylori-infected (Hp +) than in non-infected (Hp -) patients, but there has been no evaluation of the short-term clinical response. MATERIAL AND METHODS: Results of the first week of treatment with rabeprazole in Hp+ and Hp- patients with gastroesophageal reflux disease (GERD) were compared in a large prospective open-label, multicenter, cohort study in general and specialized practices. GERD patients were recruited on the basis of either typical symptoms alone or endoscopic results, assessed for H. pylori infection and treated with rabeprazole (20 mg). Heartburn and regurgitation symptoms were assessed daily during the first 7 days. Outcome parameters were calculated for both symptoms and compared between Hp+ and Hp- patients. RESULTS: Data on 1548 patients (74.5% Hp-, 25.5% Hp + ) were available. Mean heartburn and regurgitation scores decreased during the first week. For both symptoms, more than 70% of the patients had "adequate" symptom relief at day 5, and more than 80% at day 7. "Complete" symptom relief was reached in more than 70% of patients. Mean onset of adequate symptom control was about 4 days. In Hp+ and Hp- patients there was no difference in response for any of the parameters. CONCLUSIONS: Among patients treated with rabeprazole in clinical practice, H. pylori infection or its absence has no effect on the speed or degree of GERD symptom relief. Infected patients and non-infected patients can therefore be treated with a similar dose. When treating heartburn with rabeprazole, physicians do not need to consider the patient's H. pylori status and most patients (>80%) have adequate symptom relief after just a few days of treatment.  相似文献   

17.
老年胃食管反流病患者临床特征分析   总被引:1,自引:0,他引:1  
目的 探讨老年胃食管反流病(GERD)患者的临床特征,为临床诊断、治疗提供帮助.方法 根据GERD蒙特利尔的标准、中国胃食管反流病共识意见等,将GERD患者分为老年组(年龄≥65岁)与中青年组(年龄<65岁);通过问卷调查,分析2组GERD患者的食管裂孔疝(HH)、食管炎(洛杉矶标准)、临床症状(反流、烧心等)、生活质量.结果 两组性别比差异无统计学意义(P>0.05).与中青年GERD患者比较:老年患者重度食管炎(LC级+LD级)比例高(P<0.05);典型反酸、烧心症状轻(P<0.05),食管外症状发生率高(P<0.05);但HH发生率差异无统计学意义(P>0.05).老年患者生理功能、总体健康、活力、社会功能、精神健康、躯体生理健康总评和精神心理健康总评积分与年轻组差异无统计学意义(P>0.05),仅生理职能、躯体疼痛、情感职能积分较中青年组高(P<0.05).结论 老年GERD患者典型反流症状(反食、烧心)较少见,易发生重度食管炎,但老年GERD患者生活质量无明显下降.  相似文献   

18.
AIM: To investigate the impact of heartburn and regurgitation on the quality of life among patients with gastroesophageal reflux disease (GERD).METHODS: Data from patients with GERD, who were diagnosed according to the Montreal definition, were collected between January 2009 and July 2010. The enrolled patients were assigned to a heartburn or a regurgitation group, and further assigned to an erosive esophagitis (EE) or a non-erosive reflux disease (NERD) subgroup, depending on the predominant symptoms and endoscopic findings, respectively. The general demographic data, the scores of the modified Chinese version of the GERDQ and the Short-form 36 (SF-36) questionnaire scores of these groups of patients were compared.RESULTS: About 108 patients were classified in the heartburn group and 124 in the regurgitation group. The basic characteristics of the two groups were similar, except for male predominance in the regurgitation group. Patients in the heartburn group had more sleep interruptions (22.3% daily vs 4.8% daily, P = 0.021), more eating or drinking problems (27.8% daily vs 9.7% daily, P = 0.008), more work interferences (11.2% daily vs none, P = 0.011), and lower SF-36 scores (57.68 vs 64.69, P = 0.042), than patients in the regurgitation group did. Individuals with NERD in the regurgitation group had more impaired daily activities than those with EE did.CONCLUSION: GERD patients with heartburn or regurgitation predominant had similar demographics, but those with heartburn predominant had more severely impaired daily activities and lower general health scores. The NERD cases had more severely impaired daily activity and lower scores than the EE ones did.  相似文献   

19.
目的探讨妊娠晚期胃食管反流病的特点。 方法收集2014年1月至2015年12月,在乌鲁木齐市友谊医院妇产科收治的82例妊娠晚期妇女临床资料,记录孕产史,胃灼热和反酸症状的频率及程度,分析妊娠晚期妇女胃食管反流症状的特点。 结果其中62例(76%)孕妇有胃灼热症状,58例(71%)孕妇有反酸症状,20例无症状,平均孕周为(33.8±3.7)周,35例(43%)孕妇有胃灼热和反酸家族史,54例经产妇(65%)在既往的妊娠期出现过胃灼热症状,57例(70%)怀孕前无症状。 结论妊娠期胃食管反流症状发病率明显升高,胃食管反流具有家族性特点,既往妊娠期与本次妊娠晚期出现的胃灼热症状具有相关性。  相似文献   

20.
目的评价熊去氧胆酸(UDCA)联合雷贝拉唑对非糜烂性胃食管反流病(NERD)的疗效。方法 156例军人NERD患者随机分为A组(UDCA 250 mg 2次/d)、B组(雷贝拉唑20 mg 1次/d)、C组(UDCA 250 mg 2次/d和雷贝拉唑20 mg 1次/d),共治疗4周,每组各52例;疗效应用症状积分来评价。结果 UDCA和雷贝拉唑各单独应用,对NERD均具有一定的治疗效果,两组在治疗后第1、2、3、4周,对烧心缓解,UDCA比雷贝拉唑差,但差异无统计学意义(P0.05);对口苦缓解,雷贝拉唑比UDCA差,但差异无统计学意义(P0.05),但雷贝拉唑缓解反酸明显优于UDCA(P0.01)。两药合用缓解NERD的症状缓解率为83.3%,明显高于A组(16.7%)和B组(25.0%),差异有统计学意义(P0.01),总有效率为100%,明显高于A组(66.7%)和B组(83.3%),差异有统计学意义(P0.01);A组与B组的缓解率和总有效率比较,差异均无统计学意义(P0.05)。结论 UDCA联合雷贝拉唑治疗NERD临床疗效明显提高;UDCA可减少胆汁反流对食管黏膜的刺激。  相似文献   

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