胃食管反流病发病机制研究进展

胃食管反流病(GERD)是消化系统常见疾病,临床表现复杂多样,常见反酸、烧心、嗳气、反食,亦可伴有咽、喉等食管外组织损伤表现,如咽喉炎、慢性咳嗽和哮喘,甚至咽部异物感、堵塞感。根据内镜和病理结果,目前公认的分类为:非糜烂性反流病、反流性食管炎、Barrett食管。西方国家发病率较高,我国GERD发病率亦逐年提高。GERD是严重影响人们健康和生活质量的疾病,但其发病因素较多,发病机制仍不十分清楚,近年来对GERD的研究有较大进展,就GERD的发病机制研究进展予以综述。     

胃食管反流病的病因分析及其发病机制研究

本文从反流物的攻击作用、抗反流屏障的削弱、食管粘膜的防御作用降低和胃排空延迟等四个方面,对胃食管反流病的病因既发病机制进行了分析和探究,以期为更好地控制和治疗胃食管反流病提供参考价值。     

胃食管反流病的病因分析及其发病机制研究

本文从反流物的攻击作用、抗反流屏障的削弱、食管粘膜的防御作用降低和胃排空延迟等四个方面,对胃食管反流病的病因既发病机制进行了分析和探究,以期为更好地控制和治疗胃食管反流病提供参考价值。     

从脑肠轴探讨胃食管反流病伴抑郁症发病机制的研究进展

胃食管反流病(GERD)是以反酸、烧心为主要症状的一种疾病,多数患者伴有顽固性咳嗽、咽部不适和焦虑抑郁等,临床发现GERD患者易并发抑郁症,脑肠轴是两者共病的发病基础。本文从脑肠肽、5-羟色胺系统、肠道微生物、下丘脑-垂体-肾上腺轴、炎性细胞因子探讨GERD伴抑郁症的发病机制,也为研发治疗两者共病的新药提供科学依据。     

胃食管反流病的中西医研究进展

胃食管反流病(gastroesophageal reflux disease,GERD)是消化科多发病、常见病和难治性疾病。本片综述了中医和西医对胃食管反流病的病因病机及治疗原则的研究现状及进展,归纳总结了中西医治疗胃食管反流病的临床经验,为临床上治疗本病提供了一定的理论依据。     

胃食管反流病

胃食管反流病(GERD)并不少见。只是人们对本病还不认识，致使不少病人长期被误诊。GERD不但可引起食管炎，还可导致咽、喉、气道等处损害，因此其症状多种多样，轻重不一。烧心、反酸是其典型症状。病人感觉胸骨后或剑突下烧灼感，多由胸骨下段向上伸延，常在餐后一小时出现。部分病人可因食管炎而出现吞咽疼痛，有时病人甚至因食管痉挛变细或功能紊乱，     

针灸治疗胃食管反流病的研究进展

胃食管反流病是临床常见的消化系统疾病,本病因多种原因导致胃或者十二指肠的内容物倒流进入食道而出现反酸、烧心等反流典型症状。胃食管反流病难以根治,且易反复迁延,给患者带来了沉重的身心及经济负担,故胃食管反流病治疗的研究一直是医学界的热点。中医治疗本病效果明确,中医外治法治疗本病的优势逐渐显现,其不仅操作简便、经济成本低,且疗效甚佳,得到医者及患者的广泛关注,而针灸疗法在中医外治法中占有举足轻重的地位,极具中医特色,归纳针刺疗法在胃食管反流病中的应用可以为本病治疗提供可靠思路。归纳近年来针灸治疗胃食管反流病临床上的应用,以期为治疗胃食管反流病方面提供些许借鉴。     

胃食管反流病

问：近来．我总是感觉反酸、烧心,尤其是餐后1小时．特别不舒服。我是不是得了胃食管反流病？需要做胃镜吗？     

具有哮喘表现的胃食管反流病的发病情况调查分析

目的探讨具有哮喘表现的胃食管反流病（GERD）患者的发病特点,减少误诊误治。方法调查于2005年1月～2009年12月期间在笔者所在医院消化内科就诊及行胃镜检查的患者并诊断为GERD者1259例中的具有哮喘表现的患者114例,同期随机调查在笔者所在医院内科门诊就医的非GERD患者共1458例中的具有哮喘表现的患者74例。应用统计学方法将两组调查情况进行比较分析。结果具有GERD伴哮喘组的发病年龄明显高于非GERD哮喘组;GERD伴哮喘组的男女性的比率高于非GERD哮喘组。GERD伴哮喘组的平均体重指数明显高于非GERD哮喘组,吸烟、饮酒、体力劳动、家族史以及幽门螺杆菌感染人数也均高于非GERD哮喘组。结论本调查中两组发病情况的比较结果可有助于医务人员在临床工作中对GERD伴哮喘和普通人群的哮喘进行早期诊断和治疗,有助于改善患者的生活质量,降低误诊误治的发生机率,减少GERD患者和哮喘患者的合并症,有利于改善预后。     

与老人谈胃食管反流病

我今年62岁，经常出现烧心、反胃、胸骨后疼痛等症状。别人说我患了胃食管反流病。请问：这种病是怎样发生的，应该如何诊断?     

Gastroesophageal reflux disease

The present paper reviews the present state of gastro-oesophageal reflux disease (GERD), a clinical entity of great prevalence in the western population. We examine the progress made in the understanding of the pathogeny of this disease, determined to a large degree by the introduction of functional explorations, such as esophagic manometry and 24 hour pH-manometry, which have contributed information of great physiopathological interest. We describe typical and atypical or extra esophageal clinical manifestations, while bringing up to date the diagnostic methodology. Finally, we review the present state of treatment in its pharmacological, endoscopic and surgical facets     

Gastroesophageal reflux disease

Heartburn on 2 or more days a week warrants medical attention, as patients are likely to suffer from gastroesophageal reflux disease (GERD). Chronic GERD can lead to the development of complications including erosive esophagitis, stricture formation, and Barrett's esophagus, which increases the risk of esophageal adenocarcinoma. A trial with a proton pump inhibitor (PPI) is the quickest and most cost-effective way to diagnose GERD, and is at least as sensitive as 24-hour intra-esophageal pH monitoring. As PPIs only bind to actively secreting proton pumps, they should be dosed 30 to 60 minutes before a meal. Despite these recommendations, a recent survey of over 1000 US primary care physicians found that 36% instructed their patients to take a PPI with or after a meal or did not specify the timing of dosing. The patients who will have the best response to surgical therapy for GERD are those who had clearly documented acid reflux with typical symptoms, and who have responded to PPI treatment. Unfortunately, the same survey found that most physicians recommend antireflux surgery for patients in whom medical therapy has failed.     

Gastroesophageal reflux in the adolescent

Gastroesophageal reflux (GER) is relatively common in adolescence. The severity of gastrointestinal symptoms associated with gastroesophageal reflux varies from an occasional burp to persistent emesis. Evaluation of most of these patients reveals no definable anatomic, metabolic, infectious, or neurologic etiology. The clinical determination of a cause-and-effect relationship between GER and other disorders, including associated respiratory disease, is often difficult and must be approached with considerable caution. Tests that merely document the presence of GER add little to the diagnosis. The adolescent with GER often has persistent symptoms of esophagitis that lead to appropriate intervention. Understanding the capabilities and limitations of the various diagnostic maneuvers available to assess GER is important to avoid subjecting these patients to invasive, costly, and inappropriate testing. This article includes a general discussion of physiology, diagnostic evaluation, and therapy of GER, followed by a review of respiratory and other complications.     

Gastroesophageal reflux in adolescents

Gastroesophageal reflux disease (GERD) occurs in adolescents but its frequency and severity is less than in adults. Typical symptoms of heartburn and regurgitation generally do not require a diagnostic evaluation unless they are associated with alarm signs including odynophagia, dysphagia, upper gastrointestinal bleeding, weight loss, atypical chest pain, or respiratory disease. Empiric treatment with proton pump inhibitors (PPIs) provides relief in most patients. Patients with persistent symptoms requiring PPI therapy should undergo endoscopy. Those with chronic GERD require medical or surgical therapy, whereas those with nonerosive reflux disease often benefit from changes in lifestyle or intermittent, on-demand medical therapy with a therapeutic aim of symptom relief. Surgical therapy is rarely required but may have a role in adolescents with respiratory complications of gastroesophageal reflux or neurologic handicap.     

Gastroesophageal reflux disease in adults: pathophysiology, diagnosis, and management.

Gastroesophageal reflux disease (GERD) refers to symptoms or tissue damage that result from gastroesophageal reflux. Reflux esophagitis is a subset of GERD and implies the presence of esophageal inflammation, ie, esophageal erosions that are visible endoscopically, or nonerosive inflammation that can be documented by biopsies. Heartburn is the most common and specific symptom of GERD. In some patients, chest pain or respiratory symptoms may be the only presenting signs. In patients aged < 50 years with uncomplicated GERD, empiric therapy (typically with antacids or an H2-receptor antagonist) is appropriate. For older patients, those with complications, and those whose symptoms do not respond to empiric therapy, endoscopic evaluation is indicated. Many patients will improve with standard twice-daily dosing of an H2-receptor antagonist. However, GERD is generally more resistant to antisecretory pharmacologic therapy than is peptic ulcer disease. Those patients who fail to respond to standard dosing of an H2-receptor antagonist may get relief from high-dose H2-receptor antagonists or omeprazole therapy.     

Gastroesophageal reflux disease in mentally retarded persons: prevalence, diagnosis and treatment

The prevalence of gastroesophageal reflux disease among institutionalised intellectually disabled individuals with an IQ < 50 is high: about 50% have an deviant 24-hour pH measurement and 70% of them have refluxoesophagitis. Intellectually disabled individuals have an increased risk of gastroesophageal reflux disease in case of cerebral palsy, IQ < 35, scoliosis, use of anticonvulsant drugs or benzodiazepines, not being ambulant, and in case of symptoms such as haematemesis, rumination or dental erosions. To establish the diagnosis is difficult because of the aspecific symptoms. Reflux disease is only diagnosed at a late stage. 24-hour pH measurement should be used in all those intellectually disabled individuals in whom gastroesophageal reflux disease is clinically suspected. For the treatment of gastro-oesophageal reflux disease in adults as well as children, proton pump inhibitors are highly effective, independent of the severity of oesophagitis. Marked improvement of symptoms and quality of life can be noticed after treatment.     

疾病负担研究现状及高血压疾病负担研究进展

高血压是重要的心脑血管疾病致病因素,它以动脉压升高为主要特征。《中国高血压防治指南》对高血压的定义为收缩压≥140mmH或舒张压≥90mmHg。高血压可造成心脏、血管、脑与肾脏等靶器官损害以及代谢改变等全身性疾病,是脑血管疾病、缺血性心脏病、心脏和肾功能衰竭的主要病因。因此,客观、正确、全面、系统地评价高血压疾病负担,可为政策制定者制定高血压预防和治疗方案提供参考依据。