雷贝拉唑对反流性食管炎患者生活质量的影响

反流性食管炎(RE)患者胃和(或)十二指肠内容物反流入食管引起烧心、反酸、胸骨后疼痛等症状,并造成食管黏膜病理性损害,患者的心理状态和生活质量亦受影响.随着医学模式的日趋完善,社会和心理因素与疾病的关系逐渐引起重视,生活质量是衡量疾病及治疗措施对躯体、心理和社会活动影响的综合指标.本研究采用36项健康状况调查(SF36)量表[1],对RE患者雷贝拉唑治疗前、后生活质量进行问卷调查,评价该药对RE患者生活质量的影响.     

雷贝拉唑+针灸治疗非糜烂性反流病的临床观察

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。     

埃索美拉唑治疗反流性食管炎的临床观察

目的探讨新一代质子泵抑制剂埃索美拉唑对反流性食管炎(RE)的临床疗效。方法将128例经内窥镜证实的RE患者随机分为2组,A组68例,给予埃索美拉唑40mg,每日1次;B组60例,给予奥美拉唑20mg,每日2次;两组疗程均为8周,两组均同时加用促动力剂西沙比利。分别于治疗2、4、6、8周后记录烧心、反酸和胸骨后灼痛等症状记分,判断疗效,并于8周后复查胃镜,观察胃镜下愈合率。结果治疗8周时,上述3种主要症状总体疗效为:A组显效率为83.8%(57/68),总有效率为97.0%(66/68);B组显效率为58.3%(35/60),总有效率为73.3%(43/60);两组比较差异有显著性(P<0.05)。两组在内镜下食管炎愈合率、总有效率方面存在显著性差异(P<0.05)。结论埃索美拉唑是治疗反流性食管炎的有效药物。     

雷贝拉唑试验对胃食管反流病的诊断价值

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     

联合应用雷贝拉唑、铝碳酸镁和莫沙比利治疗反流性食管炎近期疗效分析

目的探讨雷贝拉唑、铝碳酸镁和莫沙比利联合治疗反流性食管炎的临床疗效。方法将82例经内镜确诊的反流性食管炎患者随机分为治疗组：雷贝拉唑（10mg，qd），铝碳酸镁（1．0g，tid），莫沙比利（5mg，tid）；对照组Ⅰ：奥美拉唑（10mg，qd），铝碳酸镁（1．0g，tid），莫沙比利（5mg，tid）；对照组Ⅱ：法莫替丁（20mg，bid），铝碳酸镁（1．0g，tid），莫沙比利（5mg，tid），疗程一周，记录治疗前和用药期间烧心、反酸、嗳气、胸骨后疼痛等症状的变化及有无不良反应出现。结果三组均能有效缓解反流性食管炎的临床症状．但治疗组在一日缓解率、平均症状消失天数、及夜间烧心症状缓解率上与对照组相比有明显差异。结论联合应用雷贝拉唑、铝碳酸镁和莫沙比利治疗反流性食管炎能迅速缓解症状．提高生活质量。     

反流病诊断问卷评分低下的原因分析

目的 分析反流病诊断问卷(RDQ)评分低下患者的临床特征及原因.方法 回顾性比较和分析1 48例确诊为胃食管反流病(GERD)患者中22例RDQ积分＜12分者和126例积分≥12分者的临床特征.对两者胸骨后疼痛、烧心、反酸、反食的程度及频率等进行对比分析,同时,对RDQ低分病例的不典型症状如胸闷、咽部异物感、嗳气,失眠、焦虑等出现的百分率进行分析.结果 ①22例RDQ平均积分为7.59±2.48,其中最高11分.最低仅2分,出现胸骨后疼痛例数最多,有16例.②RDQ低分者与高分者在胸骨后疼痛方面症状积分差异无统计学意义(P＞0.05),前者烧心、反酸、反食的症状积分明显低于后者.差异有统计学意义(P＜0.05).③对16例胸骨后疼痛病例进行独立症状积分分析,胸骨后疼痛积分约占RDQ总分的60.28%,而反酸、烧心、反食分别只占16.80%、12.29%、10.63%.④不典型症状如胸闷、胸骨后不适、咽部异物感、咳嗽和气喘、头痛、嗳气、失眠及焦虑分别占总例数的59.09%(13例)、36.36%(8例)、13.63%(3例)、22.72%(5例)、40.90%(9例)、36.36%(8例)及27.27%(6例).结论 RDQ对于有胸骨后疼痛症状.但反酸、反食、烧心症状不明显者以及RDQ外的不典型症状GERD患者不敏感.     

症状积分评价熊去氧胆酸联合雷贝拉唑治疗军人NERD的疗效

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。     

雷贝拉唑对胃食管反流病患者生活质量的影响

目的比较反流性食管炎(RE)和非糜烂性胃食管反流病(NERD)患者在雷贝拉唑治疗后生活质量的变化。方法2002年12月至2003年6月在国内进行了多中心观察雷贝拉唑(10mg,每天2次口服)8周治疗RE和NERD患者的疗效。共入选RE患者74例和NERD患者37例。治疗前后采用问卷调查方式了解生活质量,问卷包括胃食管反流病-生活质量问卷量表(GERD-HRQL)和SF-36健康量表。结果(1)治疗后所有患者症状改善均为显效,RE患者糜烂愈合率达94.6%。(2)RE患者在SF-36健康量表中7个维度有明显改善,与治疗前比较差异有统计学意义(P<0.05)。NERD患者仅在总体健康和活力2个维度有明显改善(P<0.05)。(3)RE和NERD两组比较,治疗前在SF-36健康量表中NERD患者在活力、躯体疼痛和总体健康3个维度上低于RE患者;治疗后RE患者6个维度值高于NERD患者(P<0.05),GERD-HRQL评分也明显低于NERD组。结论有效抑酸治疗可以理想地控制GERD患者的症状,但是NERD患者生活质量的改善不如RE患者,说明NERD患者的发病是多因素的,在治疗上更应强调综合整体治疗。     

兰索拉唑与莫沙必利联合治疗反流性食管炎

目的　观察兰索拉唑与莫沙必利联合治疗反流性食管炎临床效果。方法　 89例反流性食管炎患者随机分两组 ,治疗组 5 0例用兰索拉唑和莫沙必利 ,对照组 3 9例用盐酸雷尼替丁胶囊加用加斯清 ,观察治疗前及治疗后 4、8周的临床症状改善和内镜变化。结果　用药 4周时 ,治疗组返酸、烧心及胸骨后疼痛明显好转 ,与对照组相比差异有统计学意义 ,P <0 0 5。用药 8周结束时 ,治疗组返酸、烧心及胸骨后疼痛全面改善 ,总有效率分别是 98 0 %、97 8%和 93 % ,明显优于对照组的 64 1%、81 1%和 73 3 % ,P <0 0 5 ) ;内镜 4周、8周复查治疗组与对照组食管粘膜病损愈合率分别为 84 0 %和 61 5 % ,96 0 %和 76 9% ,差异有显著性意义 ,P<0 0 5。结论　兰索拉唑、莫沙必利联合用药是治疗反流性食管炎安全、有效的方法     

枳术宽中胶囊联合莫沙必利和雷贝拉唑钠治疗反流性食管炎临床疗效及对血清MOT、GAS与炎症因子的影响

[目的]探究枳术宽中胶囊联合莫沙必利和雷贝拉唑钠治疗反流性食管炎临床疗效及对血清胃动素(MOT)、胃泌素(GAS)与炎症因子的影响。[方法]选取2016年6月～2018年5月在我院接受治疗的反流性食管炎患者90例,按随机方法分为对照组和观察组,每组各45例。对照组采用枸橼酸莫沙必利片与雷贝拉唑钠肠溶片治疗。观察组在对照组的基础上口服枳术宽中胶囊治疗,2组患者均连续治疗8周。比较2组治疗临床疗效、临床症状积分、血浆MOT和血清GAS、血清炎症因子及不良反应。[结果]观察组的治疗总有效率明显高于对照组(95.56%:82.22%,P=0.044);治疗后对照组与观察组的临床症状评分均低于治疗前(P0.05),且同期观察组烧心、反酸与胸骨后疼痛症状评分低于对照组(P0.05);治疗后2组患者MOT和GAS水平均明显高于治疗前(P0.05),且观察组治疗后的MOT和血清GAS水平明显高于对照组(P0.05);治疗后2组患者血清炎症因子含量明显低于治疗前,且观察组治疗后血清炎症因子明显低于对照组(P0.05)。2组患者不良反应发生率比较差异无统计学意义(P0.05)。[结论]枳术宽中胶囊联合莫沙必利和雷贝拉唑钠可有效地改善患者临床症状,治疗反流性食管炎疗效显著,值得在临床上推广应用。     

A randomized, prospective, comparative, multicenter study of rabeprazole and ranitidine in the treatment of reflux esophagitis]

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.     

Symptom relief in patients with reflux esophagitis: comparative study of omeprazole, lansoprazole, and rabeprazole

BACKGROUND AND AIM: Rabeprazole has a faster onset of antisecretory activity than omeprazole and lansoprazole. The aim of the present study was to clarify whether there is any difference in the speed of symptom relief in patients with reflux esophagitis following the administration of these three proton pump inhibitors (PPI). METHODS: Eighty-five patients with erosive reflux esophagitis were randomized to receive 8 weeks of 20 mg of omeprazole (n = 30), 30 mg of lansoprazole (n = 25), or 20 mg of rabeprazole (n = 30) once a morning. Daily changes in heartburn and acid reflux symptoms in the first 7 days of administration were assessed using a six-point scale (0: none, 1: mild, 2: mild-moderate, 3: moderate, 4: moderate-severe, 5: severe). RESULTS: The mean heartburn score in patients administered rabeprazole decreased more rapidly than those given the other PPI. Complete heartburn remission also occurred more rapidly in patients administered rabeprazole (compared with omeprazole: P = 0.035, compared with lansoprazole: P = 0.038 by log-rank test). No differences were seen in the rate of endoscopic healing of reflux esophagitis at 8 weeks between the three treatment regimens. CONCLUSION: Rabeprazole may be more effective than omeprazole and lansoprazole for the rapid relief of heartburn symptoms in patients with reflux esophagitis.     

Rabeprazole is equivalent to omeprazole in the treatment of erosive gastro-oesophageal reflux disease: A randomised, double-blind, comparative study of rabeprazole and omeprazole 20 mg in acute treatment of reflux oesophagitis, followed by a maintenance open-label, low-dose therapy with rabeprazole

BACKGROUND: Previous studies have shown similar effects of rabeprazole and omeprazole, when used at the same dose in the treatment of reflux oesophagitis. However, such studies have been conducted as superiority studies but interpreted as equivalence ones. AIM: To properly assess the comparative efficacy of rabeprazole and omeprazole in inducing complete endoscopic healing and symptom relief in patients with reflux oesophagitis. METHODS: Patients (n=560) with Savary-Miller grade I-III reflux oesophagitis were randomised in a double-blind, double-dummy fashion to rabeprazole or omeprazole 20 mg once daily for 4-8 weeks. Then, patients endoscopically healed and symptomatically relieved were openly maintained with rabeprazole 10 mg or 2x10 mg once daily (in the event of clinical and/or endoscopic relapse) for a maximum of 48 weeks. RESULTS: After 4-8 weeks of treatment, healing (primary end-point) was observed in 228/233 (97.9%) patients in the rabeprazole group and in 231/237 (97.5%) in the omeprazole one (equivalence effect demonstrated by p<0.0001 at Blackwelder test and an upper confidence limit at 97.5% of 0.023). However, rabeprazole was faster in inducing heartburn relief than omeprazole (2.8+/-0.2 versus 4.7+/-0.5 days of therapy to reach the first day with satisfactory heartburn relief, p=0.0045 at log-rank test). In the maintenance phase, 15.2% of patients had an endoscopic and/or clinical relapse. CONCLUSION: Rabeprazole is equivalent to omeprazole in healing reflux oesophagitis, but shows a faster activity on reflux symptoms in the early treatment phase.     

泮托拉唑合旋覆代赭汤治疗反流性食管炎

目的：观察伴托拉唑合旋覆代赭汤治疗反流性食管炎(RE)的疗效。方法：60例经内镜证实的RE患者，随机分为两组，治疗组30例，予以伴托拉唑40mg，1次／d口服，同时服用中药旋覆代赭汤100m1，3次／d口服；对照组30例，予以奥美拉唑20mg，1次／d口服，同时服用旋覆代赭汤100m1，3次／d，疗程均为4周。两组分别记录治疗前后反酸、烧心、胸痛、胃胀等症状积分，于4周后复查内镜。结果：两组治疗后1周，烧心、反酸、胸痛、胃胀等症状积分较治疗前均明显下降(均P＜0．01)，4周后达到缓解。治疗组内镜下食管炎治愈率为80．0％，有效率为93．3％，与对照组(76．7％及90．0％)比较，差异无显著性意义(P＞0.05)。结论：国产伴托拉唑治疗RE与奥美拉唑的疗效相同。     

多中心临床观察雷贝拉唑联合多潘立酮治疗胃食管反流病的症状缓解情况

目的 观察雷贝拉唑联合多潘立酮治疗胃食管反流病(GERD)的临床疗效.方法 采用多中心、随机、开放、观察性研究方法,将收集的130例GERD门诊患者随机分为观察组(雷贝拉唑联合多潘立酮)64例和对照组(单用雷贝拉唑)66例,以胃食管反流病诊断问卷(GERD Q量表)和一般资料调查方式进行症状评分,症状评分根据烧心、反流、上腹痛等发生的频率和程度.随访4周,比较治疗后2周末和4周末两组患者症状的改善情况.结果 治疗前观察组和对照组GERD Q评分值基线一致,治疗2周末,两组GERD症状GERD Q评分值均有明显下降,分别为8.45±2.53和9.17±2.42;治疗4周末疗效更明显,分别为6.03±1.54和6.70±1.78;治疗前后差异有统计学意义(t=16.113,t=14.149;P值均＜0.01).观察组在治疗2周和4周末GERD Q分值较对照组下降更快,差异有统计学意义(t=-1.658,P=0.050;t=-2.292,P=0.012).观察组和对照组治疗2周后GERD症状分值均明显下降(t=2.006,P=0.047),4周后反流症状分值有明显下降,差异有统计学意义(t=2.287,P=o.022).治疗2周末观察组烧心和反流症状总有效率为79.0％和73.0％,对照组为67.7％和69.7％,观察组优于对照组;但治疗4周末观察组和对照组总有效率相似.结论雷贝拉唑联合多潘立酮能更快缓解GERD烧心和反流症状.     

雷贝拉唑和铝碳酸镁治疗胆囊切除术后伴胆汁反流的胃炎作用比较

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.     

Investigation of pretreatment prediction of proton pump inhibitor (PPI)-resistant patients with gastroesophageal reflux disease and the dose escalation challenge of PPIs��TORNADO study: a multicenter prospective study by the Acid-Related Symptom Research Group in Japan

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.     

Rabeprazole versus ranitidine for the treatment of erosive gastroesophageal reflux disease: a double-blind, randomized clinical trial. Raberprazole Study Group

OBJECTIVE: The objective of this study was to compare the efficacy and safety of the proton pump inhibitor rabeprazole to that of the histamine-2 (H2)-receptor antagonist ranitidine in the treatment of erosive gastroesophageal reflux disease. The primary indicator of efficacy was the absence of esophageal erosions or ulcerations as determined by posttreatment endoscopy. Secondary indicators of efficacy included improvement in frequency and severity of daytime and nighttime heartburn. METHODS: A total of 338 patients were enrolled and randomly assigned to therapy with rabeprazole 20 mg once daily in the morning or to ranitidine 150 mg four times daily. At baseline and at 4 wk, patients underwent endoscopy for evaluation of esophageal lesions. Patients whose lesions healed by wk 4 had therapy discontinued; others remained on therapy and had repeat endoscopy at 8 wk. Also recorded at study visits were patients' ratings of heartburn symptoms and overall sense of well being, patients' reports of time lost from daily activities, antacid use, and adverse events. Serum gastrin levels were measured and argyrophil enterochromaffin-like cell histology evaluated at baseline and when the patient ended therapy. RESULTS: At wk 4, healing was observed in 59% (98/167) of patients assigned to rabeprazole therapy, compared with 36% (60/169) of those receiving ranitidine (p < 0.001). By 8 wk, healing was seen in 87% (146/167) and 66% (112/169) of patients in the rabeprazole and ranitidine groups, respectively (p < 0.001). There were also significant differences between the two groups favoring rabeprazole with respect to resolution or improvement of heartburn symptoms and improvement in sense of well-being. No drug-related serious adverse events were seen with either therapy; fewer patients assigned to rabeprazole had treatment-emergent signs and symptoms. Serum gastrin levels increased over baseline in the rabeprazole group, but the mean value remained within normal limits. CONCLUSIONS: Rabeprazole was superior to ranitidine in esophageal healing and symptom relief in patients with erosive gastroesophageal reflux disease, and was equally well tolerated.     

法莫替丁治疗反流性食管炎多中心临床观察

目的　探讨不同剂量法莫替丁 (商品名 :高舒达 )对反流性食管炎 (RE)的疗效。方法　上海地区 4家医院将 89例经内镜证实的 (洛杉矶分级A级和B级 )RE患者随机分为两组 ,A组 4 6例予以法莫替丁 2 0mg ,每日 2次 ;B组 4 3例予以双倍剂量 ,即 4 0mg ,每日 2次。分别于治疗后 2、4、6、8及 12周观察烧心、反酸、胸痛等症状疗效 ,并于 12周后复查胃镜 ,观察镜下愈合率 ,A组中 9例、B组中 10例患者分别与治疗前及治疗后进行食管 2 4hpH监测。 结果　法莫替丁治疗 2周 ,即可见症状明显改善 ,症状记分较治疗前明显下降 (P <0 .0 1) ,继续用药至第 12周 ,症状记分较第 2周亦显著下降 (P <0 .0 1) ,两组在治疗前及治疗后不同时间症状积分下降值均差异无显著性。治疗 12周时 ,A组症状消失率为 5 2 .17% ,总有效率为 84 .78% ;B组症状消失率为 4 8.83% ,总有效率为 88.37%。两组在症状消失率及有效率方面均差异无显著性 (P >0 .0 5 )。A组食管炎内镜下愈合率为 4 7.83% ,有效率为 82 .6 1% ;B组愈合率为 4 6 .5 1% ,有效率为 86 .0 5 %。两组在内镜下食管炎愈合率及有效率方面均差异无显著性(P >0 .0 5 )。食管 2 4hpH监测显示 ,法莫替丁 4 0mg ,每日 2次患者食管酸暴露次数较治疗前明显减少(P <0 .0 5 )。结论　法莫