埃索美拉唑联合莫沙比利治疗吻合口溃疡的临床研究

目的 探讨埃索美拉唑联合莫沙比利、克拉霉素、阿莫西林治疗幽门螺杆菌(Hp)相关吻合口溃疡的效果.方法 将94例患者随机分为两组:治疗组48例,对照组46例.治疗组采用埃索美拉唑40mg每日1次,早晨空腹服用,莫沙比利5 mg每日3次,克拉霉素500 mg每日2次,阿莫西林1.0g每日2次,疗程1周;1周后继续口服埃索美...     

联合应用埃索美拉唑、铝碳酸镁和莫沙比利治疗难治性胃食管反流病

目的:探讨联合应用埃索美拉唑、铝碳酸镁和莫沙比利治疗难治性胃食管反流病(r-GERD)的临床疗效.方法:101例rGERD患者随机为A(n=36),B(n=34)和C组(n=31),分别采用埃索美拉唑 铝碳酸镁 莫沙比利、埃索美拉唑 莫沙比利及铝碳酸镁 莫沙比利治疗.4及8 wk后评价临床症状,8 wk后评价内镜下有效率.结果:治疗4 wk后,A,B和C组临床症状总改善率分别为88.9%,79.4%和61.3%,A组与B,C两组相比差异显著(χ2=7.3531,P＜0.05).治疗8 wk后,A,B和C组临床症状总改善率分别为97.2%,88.2%和71.0%,内镜下有效率分别为94.4%,85.3%和67.7%,A组临床症状总改善率和内镜下有效率与B,C组相比存在显著性差异(χ2=9.6079,P＜0.01;χ2=8.6496,P＜0.05).结论:埃索美拉唑联合铝碳酸镁和莫沙比利治疗rGERD有很高的临床疗效.     

埃索美拉唑、莫沙比利联合铝镁加治疗难治性胃食管反流病疗效观察

[目的]观察埃索美拉唑、莫沙比利联合铝镁加治疗难治性胃食管反流病(rGERD)的临床疗效。[方法]将62例rGERD患者随机分为治疗组32例和对照组30例。对照组口服埃索美拉唑、莫沙比利治疗,治疗组在对照组治疗基础上加服铝镁加混悬液,于治疗4周、8周后评价临床症状疗效,8周后评价内镜下有效率。[结果]治疗4周、8周后,治疗组临床总有效率分别为90.6%、96.9%,对照组分别为80.0%、88.7%,2组比较差异均有统计学意义(P<0.05);治疗8周后治疗组内镜下总有效率为96.9%,对照组为86.7%,2组比较差异亦有统计学意义(P<0.05)。[结论]在口服埃索美拉唑、莫沙比利治疗的基础上,加服铝镁加能提高rGERD的治疗效果。     

疏肝理气和胃降逆汤联合埃索美拉唑及莫沙比利治疗反流性食管炎48例

[目的]观察疏肝理气和胃降逆汤联合埃索美拉唑及莫沙比利治疗反流性食管炎（RE）的疗效。[方法]将88例RE随机分为2组,治疗组48例口服疏肝理气和胃降逆汤,每日2次,饭后2h服;同时早上空腹及晚上睡前服用埃索美拉唑20mg;饭前半小时服莫沙比利5mg,日3次。对照组40例仅服用埃索美拉唑及莫沙比利,用量与用法同治疗组,2组疗程均为10周。疗程结束后,复查胃镜,观察比较食管炎及反流症状的改善程度。[结果]治疗组临床症状总有效率为91．7％,对照组为62．5％（P〈0．01）;胃镜检查评价：治疗组总有效率为97．8％,对照组为78．5％（P〈0．05）。[结论]疏肝理气和胃降逆汤联合埃索美拉唑及莫沙比利治疗RE有较好的疗效。     

埃索美拉唑联合莫沙比利治疗反流性食管炎的疗效评价

目的 探讨埃索美拉唑(ESO)联合莫沙比利治疗反流性食管炎的临床疗效.方法 将80例经内镜证实为反流性食管炎的病例随机分为治疗组40例,给予埃索美拉唑40 mg,每日1次;莫沙比利5 mg,每日3次口服.对照组40例,给予奥美拉唑20 mg,每日1次口服;莫沙比利5 mg,每日3次口服.疗程均为4、8周,分别在治疗第4...     

埃索美拉唑治疗胃食管反流病57例临床观察

目的观察埃索美拉唑（耐信）治疗胃食管反流病（GERD）的临床疗效。方法随机将114例GERD患者分为两组,治疗组57例,给予埃索美拉唑注射液（耐信）40mg,静脉滴注,每日2次,应用14d后改为口服,40mg,每日2次,继续应用至28d;对照组57例,给予奥美拉唑注射液（洛赛克）40mg,静脉滴注,每日2次,连续应用14d后改为口服,40mg,每日2次,继续应用至28d。分别观察两组患者治疗前后症状积分的改变,28d时行电子胃镜检查,按症状积分下降值及电子胃镜检查结果比较其症状控制及治疗有效率的区别。结果治疗组的GERD患者服药后1d、5d、7d、14d、28d症状积分分别为9.5±3.4、7.7±2.4、7.5±2.3、5.3±2.3、3.8±1.5;而对照组分别为11.5±3.6、8.8±2.3、8.6±2.0、6.1±2.2、4.9±1.6;两者的差异有显著性（P〈0.05）。治疗组和对照组的治疗内镜显效率分别为73.68%和50.88%,总有效率为87.71%和70.18%,差异显著（P〈0.05）。结论埃索美拉唑针剂可更迅速地减轻GERD患者的典型症状,提高内镜显效率,明显改善患者生活质量。     

枸橼酸莫沙必利分散片联合埃索美拉唑治疗胃食管反流病临床研究

目的探讨联合应用埃索美拉唑和枸橼酸莫沙必利分散片治疗胃食管反流病(GERD)的临床疗效。方法将81例GERD患者随机分为两组:联合用药组(n=41)及埃索美拉唑组(n=40例),分别采用埃索美拉唑+枸橼酸莫沙必利分散片及单用埃索美拉唑,治疗4周及8周后复查内镜,并评价临床症状改善情况。结果治疗4周后和治疗8周后的联合用药组的症状积分明显低于埃索美拉唑组(P<0.05)。治疗8周后联合用药组的内镜分级改善明显高于埃索美拉唑组(P<0.05)。治疗8周后,联合用药组的治疗有效率明显高于埃索美拉唑组。结论埃索美拉唑联合枸橼酸莫沙必利分散片治疗GERD有很好的临床疗效。     

康复新液联合埃索美拉唑治疗消化性溃疡48例

[目的]观察康复新液联合埃索美拉唑治疗消化性溃疡（PU）的疗效。[方法]胃镜检查确诊的88例PU患者随机分为2组,治疗组48例,口服康复新液10ml,3次／d;埃索美拉唑40mg,1次／d。对照组40例,口服埃索美拉唑40mg,1次／d,疗程4周。治疗期间每周随防1次,记录症状转归情况。疗程结束后,胃镜复查评估溃疡愈合情况。[结果]2组比较,各项临床症状的改善和疼痛消失差异有统计学意义（P〈0．05）;PU的愈合率和总有效率治疗组为91．6％和95．8％,对照组为80．0％和85．0％,2组比较差异有统计学意义（P〈0．05）。用药期间,2组均未出现不良反应。[结论]康复新液联合埃索美拉唑治疗PU可明显改善患者临床症状,提高溃疡愈合率和总有效率。     

埃索美拉唑治疗高危老年溃疡性上消化道出血的研究

目的观察大剂量与常规剂量埃索美拉唑治疗高危老年溃疡性上消化道出血的有效性。方法以2010年6月至2013年8月在我院老年医学科住院的96例溃疡性上消化道出血的高危（Rockall评分〉5分）老年患者为研究对象,将其随机分为治疗组和对照组,2组患者均在内镜下成功的止血,2组患者的一般治疗方案相同,治疗组采用1次静滴埃索美拉唑80 mg后（30 min）,接着以8 mg/h的速度持续静脉泵入埃索美拉唑,71.5 h后改为口服埃索美拉唑40 mg（1次/d）,持续观察至第30天;对照组静滴埃索美拉唑80 mg（1次/d）,3 d后改为口服埃索美拉唑40 mg（1次/d）,持续观察至第30天,观察2组的再出血率、死亡率、平均住院日及平均住院费用。结果与对照组相比,治疗组的再出血率、死亡率、平均住院日及平均住院费用均有明显的降低（P均〈0.05）。结论对高危的老年溃疡性上消化道出血患者而言,静脉大剂量使用埃索美拉唑是有效、合理的。     

Effects of mosapride on secondary peristalsis in patients with ineffective esophageal motility

Abstract

Objective. Ineffective esophageal motility is frequently found in patients with gastroesophageal reflux diseases. Secondary peristalsis contributes to esophageal acid clearance. Mosapride improves gastrointestinal (GI) motility by acting on 5-hydroxytrypatamine₄ receptors. The authors aimed to evaluate the effect of mosapride on secondary peristalsis in patients with ineffective esophageal motility. Material and methods. After recording primary peristalsis baseline, secondary peristalsis was stimulated by slowly and rapidly injecting mid-esophageal air in 18 patients. Two separate experiments were randomly performed with 40 mg oral mosapride or placebo. Results. Mosapride had no effect on the threshold volume of secondary peristalsis during slow air distension (9.8 ± 0.97 vs. 10.2 ± 1.0 mL; p = 0.84), but decreased the threshold volume during rapid air distension (4.1 ± 0.2 vs. 4.6 ± 0.3 mL; p = 0.001). The efficiency of secondary peristalsis during rapid air distension increased with mosapride (70% [40–95%]) compared with placebo (60% [10–85%]; p = 0.0003). Mosapride had no effect on the amplitudes of distal pressure wave of secondary peristalsis during slow (94.3 ± 9 vs. 101.9 ± 9.1 mmHg; p = 0.63) or rapid air distension (89.3 ± 9 vs. 95.2 ± 8.3 mmHg; p = 0.24). Conclusions. Mosapride improves esophageal sensitivity of secondary peristalsis by abrupt air distension but has limited effect on the motor properties of secondary peristalsis in ineffective esophageal motility patients. Despite its well-known prokinetic effect, mosapride enhances the efficiency of secondary peristalsis in patients with ineffective esophageal motility through augmenting esophageal sensitivity instead of motility.     

康复新液联合埃索美拉唑及莫沙必利治疗糜烂性食管炎的疗效观察

[目的]探讨康复新液联合埃索美拉唑、莫沙必利治疗糜烂性食管炎(EE)的疗效。[方法]72例EE患者,随机分成2组,治疗组36例,给予康复新液10 ml,3次/d,埃索美拉唑20 mg,2次/d,莫沙必利5 mg,3次/d,口服。对照组36例,给予埃索美拉唑20 mg,2次/d,莫沙必利5 mg,3次/d,口服。于治疗8周后观察症状的缓解情况,同时复查胃镜观察治疗效果。[结果]8周后治疗组症状改善总有效率为94.5%,对照组为88.8%,2组比较差异无统计学意义(P0.05);胃镜复查治疗组食管炎症总有效率为97.2%,对照组为86.1%,2组比较差异有统计学意义(P0.05)。[结论]康复新液联合埃索美拉唑、莫沙必利治疗EE临床疗效较好。     

老年健康人及反流性食管炎患者食管运动功能的测定

目的比较老年和非老年健康人、反流性食管炎患者食管运动功能的异同。方法应用微气囊法对３０例老年健康人、１９７例非老年健康人、３０例老年反流性食管炎患者、４５例非老年反流性食管炎患者食管运动功能进行检测。结果（１）老年健康人食管下括约肌（ＬＥＳ）松弛时间为（８．１±０．８）秒,长于非老年健康人的（７．１±１．０）秒（Ｐ＜０．０１）,食管蠕动波压力和食管上括约肌压力〔（４０．５±２．９）ｍｍＨｇ和（４８．７±１８．１）ｍｍＨｇ,１ｍｍＨｇ＝０．１３３ｋＰａ〕低于非老年健康人的（４５．０±１０．５）ｍｍＨｇ和（５６．１±２１．２）ｍｍＨｇ（Ｐ＜０．０１）,同步收缩波发生率较非老年健康人增多（Ｐ＜０．０１）;（２）老年反流性食管炎组ＬＥＳ松弛时间〔（１０．８±１．１）秒〕延长和食管蠕动波压力〔（３３．２±２．９）ｍｍＨｇ〕降低比非老年组〔（９．２±３．７）秒、（４０．３±６．３）ｍｍＨｇ〕更明显（均为Ｐ＜０．０１）。结论（１）老年健康人有食管运动功能障碍;（２）老年反流性食管炎患者食管运动障碍比非老年患者明显。     

Effect of physical exercise on esophageal motility in patients with esophageal disease

The most common type of esophageal dysfunction associated with chest pain is gastroesophageal reflux, which may be induced by exercise. The effect of exercise on esophageal function has mainly been investigated in normal subjects or trained athletes. Few studies have investigated exercise and esophageal motility disorders. One hundred and thirty-five patients underwent ambulatory esophageal manometry and pH monitoring, before, during and immediately after moderate exercise. Patients were divided into four groups: Normal, nutcracker, diffuse spasm and gastroesophageal reflux disease (GERD). Ambulatory manometry and pH were monitored while exercising on a treadmill during which standardized boluses of water were administered. Nutcracker and diffuse spasm patients demonstrated a significant fall in esophageal wave amplitude during exercise compared to controls, which returned rapidly to pre exercise values after resting. There was no evidence of acid reflux in the non-reflux groups during exercise. Reflux was noted in 13 patients with GERD during exercise, none of whom had evidence of reflux at the onset of exercise. When these patients were classified by reflux type, the majority, 11 patients, were found to come from the combined or supine reflux group. Esophageal amplitude in nutcracker esophagus does not increase during moderate exercise. Moderate exercise provokes reflux in GERD patients with combined or supine reflux.     

肝硬化患者食管动力与肝功能障碍的关系研究

目的研究肝功能减退对食管动力的影响.方法对无腹水或经治疗腹水消退后的肝硬化患者63例,进行Child-pugh分级,和健康对照组22例分别进行食管测压及24小时pH监测.结果肝硬化组下食管括约肌压力(LESP)、远端食管蠕动波幅(PA)、蠕动时间(PD)和蠕动传导速度(PV)与对照组比较显著异常(P＜0.05).LESP在ChildC级较ChildB级显著下降(P＜0.05),与Child-Pugh分数呈负相关(r＝-0.523,P＜0.01),伴各胃食管酸反流指标显著异常和胃食管反流病(GERD)发生率升高,P均小于0.01.食管静脉曲张程度也显著影响PA、PD和PV(P＜0.05),而LESP无明显下降.结论肝硬化患者食管动力异常和胃食管酸反流的原因除食管静脉曲张外,肝功能减退使其加重和LESP下降.     

NERD患者埃索美拉唑联合莫沙必利与加强生活方式干预对照研究112例

目的:探讨NERD患者在埃索美拉唑联合莫沙必利治疗的基础上,介入加强生活方式干预的疗效.方法:112例NERD患者分为对照组(n=54)和试验组(n=58).所有病例均采用埃索美拉唑(40 mg,qd)联合莫沙必利(5 mg,tid)治疗8 wk,实验组同时进行加强干预治疗,如生活方式调整、饮食调整、心理干预及运动调养等.采用χ2检验比较两组疗效.结果:实验组58例中显效42例,有效12例,无效4例,总有效率93.10%(54/58);对照组54例中显效26例,有效18例,无效10例,总有效率81.84%(44/54).两组比较具有显著的差异性(χ2=7.39,P＜0.01).结论:在药物治疗控制症状的基础上,积极介入生活方式干预,加强了医患之间的沟通,能提高患者的依从性,可更有效地改善NERD患者的临床症状.     

The effect of mosapride on esophageal motility and bolus transit in asymptomatic volunteers

GOALS: To evaluate the effect of mosapride, a selective 5-hydroxytryptamine-4 agonist, on esophageal motility and bolus transit in asymptomatic volunteers. STUDY: Twenty healthy subjects participated in two experiments, 7 days apart, and we utilized a randomized, double-blind cross-over design with 3-day pretreatments of placebo or mosapride. All subjects underwent combined intraluminal impedance manometry. RESULTS: There was no difference in the amplitude, the duration, and the esophageal peristaltic patterns between the two pretreatments. The lower esophageal sphincter (LES) pressure and the number of transient LES relaxations did not change after mosapride vs. placebo. However, the rate of complete bolus transit in liquid swallows was higher with mosapride pretreatment (92.2%) than with placebo (84.6%; P < 0.01). The total bolus transit time in all liquid swallows showed a tendency to shorten after mosapride treatment (P = 0.06). The liquid bolus transit became faster after mosapride, especially in manometrically ineffective liquid swallows (P < 0.01). The total bolus transit time for manometrically normal viscous swallows decreased after pretreatment with mosapride (7.7 seconds; range, 6.8-9.2) in comparison with placebo (8.1 seconds; range, 7.1-11.1; P < 0.05). CONCLUSIONS: Mosapride increases the rate of complete bolus transit in the esophagus, and enhances esophageal bolus transit in asymptomatic volunteers.     

Effect of an aldose reductase inhibitor on esophageal dysfunction in diabetic patients

BACKGROUND/AIMS: Disorders of the digestive tract in diabetic patients are mainly ascribed to disorders of the vagus nerve. Although aldose reductase inhibitors (ARIs) have been shown to be effective against diabetic peripheral neuropathy, their effectiveness on diabetic digestive neuropathy remains to be evaluated. The aim of the present study is to examine the effect of an ARI on the esophageal dysfunction in diabetic patients by monitoring pH and motility of the esophagus. METHODOLOGY: Eight type 2 diabetic patients with peripheral neuropathy were administered with the ARI epalrestat (150 mg/day) for 90 days, and esophageal pH and motility were monitored before and after the ARI treatment. RESULTS: Parameters related to the gastroesophageal acid reflux and the esophageal motility, such as % time of pH<4, DeMeester score, duration of the longest reflux episode, reflux episodes longer than 5 min, ratios of peristaltic waves with the amplitude greater than 25 mmHg and ratios of effective peristalsis were remarkably improved by the ARI treatment. CONCLUSIONS: Because the present study clearly demonstrated the effectiveness of an ARI on the esophageal dysfunction in diabetic patients, ARI may be useful for the treatment of diabetic digestive disorders.