两种不同质子泵抑制剂在反流性食管炎中的成本效果观察

目的 探讨两种不同质子泵抑制剂在反流性食管炎中的成本效果.方法 选择本院80例反流性食管炎患者,上述患者随机分为观察组和对照组.观察组患者给予埃索美拉唑,对照患者给予雷贝拉唑治疗.治疗后评定成本效果.结果 观察组患者显效率和有效率之和与对照组比较,差异无统计学意义（P＞0.05）.对照组患者的成本为233×12=2769元.观察组患者的成本为176×12=2112元.对照组的成本效果之比为2769/0.925=2993.5;观察组的成本与效果之比为2112/0.95=2223.1.观察组患者和对照组同样活动一个效果单位,观察组所需费用低于对照组.结论 埃索美拉唑治疗反流性食管炎的临床效果显著,其用药成本低于雷贝拉唑,埃索美拉唑治疗反流性食管炎的治疗方案值得临床借鉴.     

两种质子泵抑制剂在反流性食管炎中的成本效果观察

目的观察观察两种质子泵抑制剂(埃索美拉唑和奥美拉唑)在反流性食管炎中的药物经济学差异。方法 80例反流性食管炎患者(均符合诊断标准)均有不同程度的反酸、烧灼感等症状,经临床相关影像学检查证实,上述患者均为2013年11月至2014年11月期间门诊收治病例。80例患者随机分为观察组和对照组。观察组和对照组分别给予奥美拉唑和埃索美拉唑治疗。分析治疗效果和成本效果。结果观察组总有效率和对照组近似,差异无统计学意义(P>0.05)。观察组和对照组的成本分别为奥美拉唑(20 mg×14片/盒,价格:1.49元/盒。)和埃索美拉唑(40 mg×7片/盒,价格110元/盒。)的费用。观察组成本为5.96元;对照组成本为440元。观察组的成本效果=5.96/0.94=6.34;对照组的成本效果=440/0.95=463.1。观察组成本效果低于对照组。结论奥美拉唑和埃索美拉唑均对反流性食管炎有良好治疗效果,但奥美拉唑的成功效果低于埃索美拉唑,奥美拉唑适合用于经济状况较差患者。     

3种质子泵抑制剂治疗反流性食管炎的成本-效果分析

目的:比较奥关拉唑、兰索拉唑与雷贝拉唑3种方案治疗反流性食管炎的经济效果.方法:采用药物经济学原理,对不同治疗方案进行成本-效果分析.结果与结论:3组治疗方案对反流性食管炎的临床疗效无显著性差异(P＞0.05),但兰索拉唑组的成本-效果优于奥美拉唑组和雷贝拉唑组.     

质子泵抑制剂联合莫沙必利治疗反流性食管炎的疗效观察

目的观察质子泵抑制剂联合莫沙必利治疗返流性食管炎的临床疗效。方法以2009年12月至2011年12月间宜宾市第一医院收治的74例RE患者为研究对象,将患者随机分为雷贝拉唑组(给予雷贝拉唑+莫沙必利治疗)和奥美拉唑组(给予奥美拉唑+莫沙必利治疗),雷贝拉唑组38例,奥美拉唑组36例。结果 74例RE患者经过8周的治疗,雷贝拉唑组患者的症状改善总有效率为97.4%,奥美拉唑组的总有效率为83.3%,两组有效率比较,差异具有统计学意义(P<0.05);经内镜检查,雷贝拉唑组患者的总有效率为97.4%,奥美拉唑组的总有效率为72.2%,两组有效率比较,差异具有统计学意义(P<0.05)。结论雷贝拉唑+莫沙必利治疗RE临床症状改善迅速,其临床疗效优于奥美拉唑+莫沙必利组。     

3种质子泵抑制剂治疗反流性食管炎的成本-效果分析

目的评价泮托拉唑、兰索拉唑和雷贝拉唑3种质子泵抑制剂(PPI)治疗反流性食管炎(RE)的成本-效果。方法选择RE患者90例,随机分为A,B,C 3组。A组予以泮托拉唑肠溶片20 mg,B组予以兰索拉唑片30 mg,C组予以雷贝拉唑片10 mg,均每日1次,3组疗程均为8周。结果 A组、B组、C组总有效率分别为89.66%,93.55%,93.33%(P>0.05),不良反应发生率分别为6.90%,6.45%和3.33%(P>0.05)。A组的治疗方案成本和成本-效果比明显低于B组和C组。结论从药物经济学角度分析,A组即泮托拉唑疗法为治疗RE的最佳方案。     

埃索美拉唑与奥美拉唑治疗反流性食管炎的临床效果对比

目的探讨埃索美拉唑与奥美拉唑治疗反流性食管炎的临床效果,为推动消化内科的治疗发展提供理论依据。方法选取2014年1~12月我院消化内科收治的100例反流性食管炎患者为研究对象,经我院伦理委员会批准,取得患者同意条件下,将其按照治疗方法的不同分为观察组和对照组,各50例。对照组患者给予奥美拉唑药物治疗,观察组患者给予埃索美拉唑药物治疗,对比两组患者在治疗后的症状改善情况。结果观察组患者的症状改善情况以及治疗总有效率优于对照组,差异有统计学意义(P<0.05)。结论利用埃索美拉唑治疗反流性食管炎,能明显改善患者的临床症状,提升治疗总有效率,值得推广应用。     

埃索美拉唑治疗反流性食管炎的疗效观察

目的探讨埃索美拉唑治疗反流性食管炎（RE）的临床疗效。方法随机将96例患者分为两组,治疗组48例给予口服埃索美拉唑40mg／d,4周后改为20mg／d,连服4周。对照组48例口服奥美拉唑40mg／d,4周后改为20mg／d,连服4周。分别于4周、8周后记录患者临床症状评分变化值和内镜下表现。结果治疗8周后埃索美拉唑改善患者的临床症状、内镜下（RE）愈合率明显优于奥美拉唑。结论埃索美拉唑是治疗RE安全有效的药物。     

埃索美拉唑与雷贝拉唑治疗反流性食管炎的疗效观察

目的 比较埃索美拉唑与雷贝拉唑治疗反流性食管炎的疗效.方法 选取反流性食管炎患者60例,随机分为2组:治疗组30例,给予埃索美拉唑40 mg,每日1次;对照组30例,给予雷贝拉唑20 mg,每日1次,疗程均为8周.结果 2组8周治愈率分别为90.0％与83.33％,差异无显著性(P＞0.05).结论 埃索美拉唑与雷贝拉唑均能24 h持续抑酸,缓解症状,对反流性食管炎均有较好的疗效.     

埃索美拉唑与奥美拉唑治疗反流性食管炎的临床药效对比分析

目的对比埃索美拉唑与奥美拉唑治疗反流性食管炎的临床药效。方法选择2015年3月至2016年5月我院收治的反流性食管炎患者104例作为此次研究对象,随机将患者分为甲、乙两组,甲组应用奥美拉唑治疗,乙组应用埃索美拉唑治疗,对比两组患者临床药效。结果乙组治疗后临床症状积分要显著低于甲组和治疗前(P<0.05);甲组治疗总有效率是82.7%,乙组治疗总有效率是98.1%,乙组临床疗效要显著优于甲组(P<0.05)。结论埃索美拉唑治疗反流性食管炎的临床药效要显著优于奥美拉唑治疗,临床症状改善更为明显,临床可首选该药物治疗。     

埃索美拉唑与奥美拉唑治疗反流性食管炎的临床对比

目的研究埃索美拉唑与奥美拉唑治疗反流性食管炎临床效果。方法根据随机数字表方法进行74例2016年2月至2017年4月收取的反流性食管炎患者分组。对照组采用奥美拉唑进行治疗,观察组采用埃索美拉唑进行治疗。就两组患者治疗前后症状积分、生活质量和反流性食管炎治疗总有效率、用药不良反应发生率进行比较。结果观察组反流性食管炎治疗总有效率明显高于对照组,P<0.05。观察组用药不良反应发生率明显低于对照组,P<0.05。治疗前两组症状积分、生活质量无显著差异,P>0.05。观察组患者治疗后症状积分、生活质量均明显优于对照组,P<0.05。结论埃索美拉唑与奥美拉唑治疗反流性食管炎临床对比,埃索美拉唑的效果更好,安全性更高,可更好改善临床症状和提升患者生活质量。     

不同质子泵抑制剂联合莫沙必利治疗返流性食管炎的效果对比研究

目的 探讨不同质子泵抑制剂联合莫沙必利治疗返流性食管炎的有效性和安全性.方法 选取我院收治的202例返流性食管炎患者,随机均分为奥美拉唑组和雷贝拉唑组,奥美拉唑组给予奥美拉唑联合莫沙必利治疗,雷贝拉唑组给予雷贝拉唑联合莫沙必利治疗.比较两组患者治疗总有效率和不良反应发生率的差异.结果 雷贝拉唑组治疗总有效率为97.0％,显著高于奥美拉唑组的86.1％ （P＜0.05）;两组患者均无严重不良反应发生,不良反应发生率比较差异无统计学意义（P＞0.05）.结论 雷贝拉唑联合莫沙必利治疗返流性食管炎疗效确切,无严重不良反应,值得临床广泛推广使用.     

Cost effectiveness of proton pump inhibitors in gastro-oesophageal reflux disease without oesophagitis: comparison of on-demand esomeprazole with conventional omeprazole strategies

OBJECTIVES: To evaluate the cost effectiveness of on-demand treatment with esomeprazole 20mg compared with two alternative omeprazole treatment strategies for the long-term management of patients with gastro-oesophageal reflux disease (GORD) without oesophagitis. DESIGN: A simple Markov model was designed to compare the cost effectiveness of on-demand esomeprazole 20mg therapy for 6 months with a strategy consisting of intermittent 4-week acute treatment courses of omeprazole 20mg once daily or a strategy consisting of continuous omeprazole treatment (20mg once daily) following acute treatment of first relapse while on no drug treatment (a commonly used conventional care strategy). Relapse probabilities were based on pooled results from two 6-month placebo-controlled clinical studies of on-demand esomeprazole 20mg treatment in patients with GORD without oesophagitis and on results from a GORD study with a 6-month untreated follow-up. The expected number of relapses per patient was used as the effectiveness measure. SETTING AND PERSPECTIVE: Patient management assumptions were based on a UK physician survey. The cost-effectiveness analysis considered UK direct medical costs from the perspective of the National Health Service. RESULTS: The pooled analysis showed that after 6 months treatment, 90% of patients could control symptoms effectively with on-demand esomeprazole 20mg. The expected number of relapses per patient was estimated at 0.10 for on-demand esomeprazole, 0.57 to 1.12 for intermittent omeprazole and 0.47 to 0.75 for conventional omeprazole treatment. The esomeprazole strategy incurred considerably lower direct medical costs (16 to 61%) than either omeprazole strategy. CONCLUSION: On-demand treatment with esomeprazole 20mg is cost effective compared with two alternative omeprazole treatment strategies in patients with GORD without oesophagitis.     

Systematic review of proton pump inhibitors for the acute treatment of reflux oesophagitis

BACKGROUND: Esomeprazole is a new proton pump inhibitor, which has been compared to omeprazole for the treatment of reflux oesophagitis in clinical trials. AIM: To compare the effectiveness of esomeprazole with the recommended dose of proton pump inhibitors in the healing of reflux oesophagitis, using omeprazole as a common comparator. METHODS: Systematic review of randomized controlled trials. Extraction and re-analysis of data to provide 'intention-to-treat' results. Meta-analysis using a Fixed Effects model. RESULTS: A meta-analysis of healing rates of esomeprazole 40 mg compared to omeprazole 20 mg gave the following results: at 4 weeks (relative risk 1.14; 95% CI: 1.10, 1.18) and 8 weeks (RR 1.08; 95%CI: 1.05, 1.10). Other proton pump inhibitors compared to omeprazole 20 mg are as follows: lansoprazole 30 mg at 4 weeks (RR 1.02; 95%CI: 0.97, 1.08) and 8 weeks (RR 1.01; 95%CI: 0.97, 1.06); pantoprazole 40 mg at 4 weeks (RR 0.99; 95%CI: 0.91, 1.07) and 8 weeks (RR 0.98; 95%CI: 0.93, 1.04); rabeprazole 20 mg at 4 weeks (RR 1.00; 95%CI: 0.87, 1.14) and 8 weeks (RR 0.98; 95%CI: 0.91, 1.05). CONCLUSIONS: Esomeprazole has demonstrated higher healing rates than omeprazole at 4 and 8 weeks. Other proton pump inhibitors (lansoprazole, pantoprazole and rabeprazole) have not shown higher healing rates when compared with omeprazole.     

反流性食管炎质子泵抑制剂治疗失败 51例分析

目的探讨反流性食管炎病人质子泵抑制剂治疗后失败的危险因素。方法回顾性分析重庆市大足区人民医院 2018年 4月至 2020年 4月 205例接受质子泵抑制剂治疗反流性食管炎病人临床资料,并依据治疗结果分为治疗成功组(胃镜检查食管黏膜完全愈合, 154例)、治疗失败组(胃镜检查食管黏膜愈合不完全或复发, 51例)。所有病人入院后给予奥美拉唑(质子泵抑制剂)或奥美拉唑联合莫沙必利(胃动力)治疗。统计并对比两组性别、年龄、民族、体质量指数( BMI)、是否吸烟、是否饮酒、家族史、是否焦虑、是否抑郁、治疗时间、是否幽门螺旋杆菌( Hp)感染、用药方式、疾病严重程度差异。再将两组有差异的信息纳入多因素 logistic回归分析模型,行量化赋值,以治疗结果为因变量(Y,失败 =1,成功 =0),明确反流性食管炎病人经质子泵抑制剂治疗后失败的危险因素。结果两组性别、年龄、民族、家族史、治疗时间、 Hp感染对比差异无统计学意义( P>     

促动力药联合质子泵抑制剂与单独质子泵抑制剂治疗胃食管反流疾病疗效的荟萃分析

本研究旨在系统评价促动力药联合质子泵抑制剂与单独质子泵抑制剂治疗胃食管反流疾病的疗效,为临床用药提供循证参考.通过检索PubMed和Embase英文数据库,收集促动力药联合质子泵抑制剂与单独使用质子泵抑制剂治疗胃食管反流疾病的随机对照研究,采用RevMan 5.3偏倚风险评分工具对纳入研究进行质量评估并按预先设定的数据...     

Evolving drugs in gastroesophageal reflux disease: pharmacologic treatment beyond proton pump inhibitors

Importance of the field: Despite the clinical success of proton pump inhibitors to treat gastroesophageal reflux disease (GERD), for the majority of patients in both gastroenterology and primary care clinics there is still a substantial group of patients (up to 40% in some studies) who do not completely respond symptomatically to a standard dose of proton pump inhibitors (PPIs). Specific explanations for these PPI noncomplete responders included transient lower esophageal sphincter relaxations (TLESRs), sensitivity to weakly acidic and/or alkaline reflux, large volume of reflux and esophageal hypersensitivity. There is a clear need for GERD therapies beyond the PPIs.

Areas covered in this review: These drug classes include the GABA_B receptor agonists (including lesogaberan and arbaclofen placarbil), mGluR5 receptor antagonists, P-CABs, cholecystokinin₂ antagonists and add-on therapies to PPIs including mosapride and rikkunshito.

What the reader will gain: Both physicians and patients are eagerly awaiting the development and FDA approval of a new class of anti-GERD medications targeting distinct mechanisms. This article provides information on pharmacologic strategies, clinical trials and side-effect profiles on several of the most promising and heavily researched compounds being developed today for the treatment of GERD symptoms and inflammation. Hopefully, this important research will help a large group of PPI noncomplete responding patients receive symptomatic relief and reduce esophageal inflammation through a unique pharmacologic mechanism in the near future.

Take home message: The treatment of GERD has greatly improved with the PPI class of therapy. Despite excellent success, there is a sizeable population of patients who do not have adequate response to therapies directed only at acid suppression. Emerging new pharmacologic treatment options show promise in further advancing the treatment success of GERD.     

国产泮托拉唑治疗反流性食管炎的疗效

目的:比较国产泮托拉唑和进口奥美拉唑治疗反流性食管炎的疗效。方法:反流性食管炎患者共86例,随机分为2组,观察组46例给国产泮托拉唑40m g,早晚各1次,疗程8周;对照组40例给进口奥美拉唑20m g,早晚各1次,疗程8周。疗程结束后内镜复查。结果:泮托拉唑组和奥美拉唑组疗效分别为:治愈91.3%和87.5%,显效4.35%和7.5%,有效4.35%和5%(P>0.05);胃镜下反流性食管炎的疗效分别为:无效2.17%和2.5%,有效4.35%和2.5%,显效2.17%和5%,治愈率91.3%和90%(P>0.05)。结论:国产泮托拉唑能明显改善反流性食管炎的临床症状和镜下表现,疗效确切,使用安全。