埃索美拉唑联合莫沙必利、铝碳酸镁治疗难治性胃食管反流病的临床观察

目的观察埃索美拉唑、铝碳酸镁、莫沙必利治疗难治性胃食管反流病(rGERD)的临床疗效。方法 120例rGERD患者随机分为3组:A组(n=40)、B组(n=40)和C组(n=40)。分别采用埃索美拉唑+莫沙必利+铝碳酸镁、埃索美拉唑+莫沙必利及铝碳酸镁+莫沙必利治疗,4周及8周评价临床症状及有效率。结果治疗8周后A组在症状评分和内镜分级均较B、C组显著改善(P<0.05)。A组4周、8周后临床症状评分有效率分别为80.0%和92.5%,3组比较差异显著(P<0.05)。结论埃索美拉唑联合莫沙必利、铝碳酸镁是治疗rGERD的有效方法。     

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。     

埃索美拉唑联合莫沙必利治疗胃食管反流病疗效观察

质子泵抑制剂（PPI）是治疗胃食管反流病（GERD）的首选药物。我们对我院2007年1月～2008年8月诊断为GERD的患者应用PPI联合促动力药治疗,取得了较好疗效。现报告如下。临床资料：选择具有反酸、烧心、非心源性胸痛和反流典型症状的患者68例,其中男41例、女27例,年龄（39±14.2）岁,均符合蒙特利尔共识的GERD标准,4周内未用过PPI和促动力药,并排除能引起反流症状的其他消化系统疾病。     

埃索美拉唑与奥美拉唑对胃食管反流病24小时胃内pH效果比较

维持胃内pH >4是有效治疗胃食管反流病 (GERD)的关键。 4 0mg埃索美拉唑是第一个光学异构体质子泵抑制剂 (PPI) ,已被证实较 2 0mg奥美拉唑有更显著的抑酸效果。此项研究的目的在于比较每天 1次埃索美拉唑 4 0mg与奥美拉唑 4 0mg对症状性GERD病人胃酸的影响。在这项开放交叉研究中 ,130例症状性GERD病人接受每天 1次埃索美拉唑 4 0mg或奥美拉唑 4 0mg连续 5d的治疗。在每个疗程的第 1天和第 5天进行 2 4h胃内pH监测。接受埃索美拉唑 4 0mg的病人第 1天和第 5天的 2 4h胃内pH >4的时间显著长于奥美拉唑 4 0mg(第 1天 :4 8.6 %比 4 0 …     

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。     

埃索美拉唑联合莫沙必利治疗重度反流性食管炎的疗效观察

目的探讨埃索美拉唑联合莫沙必利治疗重度反流性食管炎的临床疗效。方法将90例经内镜证实为Ⅱ、Ⅲ级反流性食管炎患者随机分为埃索美拉唑联合莫沙必利组（A组）、奥美拉唑联合莫沙必利组（B组）和埃索美拉唑组（C组）,三组分别口服埃索美拉唑20 mg,2次/d,莫沙必利5 mg,3次/d;口服奥美拉唑20 mg,2次/d,莫沙必利5 mg,3次/d;以及口服埃索美拉唑20 mg,2次/d治疗,疗程8周,停药后复查胃镜,观察治愈率,并记录症状改善情况及不良反应。结果治疗8周后A、B、C三组症状改善总有效率分别为96.88%、75.00%、70.00%;胃镜下有效率分别为93.75%、71.43%、66.67%,A组与其他两组比较均有显著性差异（P〈0.05）。结论埃索美拉唑联合莫沙必利治疗重度反流性食管炎有较高的治愈率和症状改善率,临床疗效明显优于奥美拉唑联合莫沙必利及单独应用埃索美拉唑治疗。     

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。     

枸橼酸莫沙必利分散片（新络纳）对功能性消化不良患者近端胃舒张和胃排空功能影响的研究

目的 探讨枸橼酸莫沙必利分散片(新络纳)对功能性消化不良(FD)患者近端胃舒张和胃排空功能的影响.方法 FD患者和健康志愿者各20例,以实时B超检查测定饮用500 ml纯净水后不同时间点近端胃容积的变化,对:FD患者服用枸橼酸莫沙必利分散片(新络纳)后于同一时间点再次以实时超声测定近端胃容积的变化.结果 FD组和对照组之间胃底气体评分有显著差异.FD组在服用枸橼酸莫沙必利分散片后与服用之前同一时间点的近端胃容积有显著性差异,与对照组之问有显著性差异.结论 FD患者近端胃舒张功能受损,枸橼酸莫沙必利分散片(新络纳)能改善胃舒张功能并加快FD患者的胃排空.     

尼扎替丁治疗老年胃食管反流病

目的观察尼扎替丁治疗老年胃食管反流病的疗效。方法将116例老年胃食管反流病随机分为3组A组40例,B组38例,C组38例,分别应用奥美拉唑20 mg、尼扎替丁150 mg、雷尼替丁150 mg,bid×4周;然后分别改为20 mg、150 mg、150 mg qd至6个月。于治疗4周、3月、6月后观察各组总有效率。结果显示B组4周、3月、6月总有效率分别为81．58％、89．47％、94．47％,与A组相比(分别为85．00％、90．00％、95．00％)无显著性差异(P＞0．05);而与C组相比(分别为65．79％、76．72％、78．95％)有显著性差异(P＜0．05)。症状积分与总有效率结果一致。结论尼扎替丁治疗老年胃食管反流病与奥美拉唑疗效相仿,优于雷尼替丁,且价廉、副作用少。     

胃食管反流病胃肌电活动的变化

目的 分析描述胃食管反流病(GERD)患者的胃肌电活动特点,探讨胃肌电活动的变化在GERD发病中的作用,以期有助于临床诊疗.方法 对65例GERD患者和30例健康志愿者进行餐前、餐后体表胃电图监测.根据内镜检查结果,把GERD患者分为反流性食管炎(RE)组、非糜烂性反流病(NERD)组,行组间胃电参数比较,随访19例胃电节律异常的GERD患者,观察治疗前后胃电参数的变化.结果 GERD组的主频(DF)正常慢波节律百分比(N%)、餐前餐后功率比(PR)与对照组相比明显降低(P<0.05或0.01).胃电节律紊乱,以胃动过缓为主.经1周治疗后,GERD异常胃电参数明显正常化(P<0.05或0.01).餐前RE组胃电节律异常的发生率(37.5%)显著高于NERD组(12.1%).餐后胃电节律异常的发生率RE组和NERD组分别为71.9%和60.6%,两者没有统计学意义(P>0.05).结论 GERD患者存在餐前、餐后胃肌电活动异常,异常胃电节律以胃动过缓节律为主,胃电图能为GERD诊断提供依据.     

探讨胃食管反流病的临床分型

目的:应用24h食管内胆红素与pH监测(食管内双监测)以及食管内镜检查对胃食管反流病(GERD)进行临床分型研究。方法:根据食管胆红素、pH双监测、食管内镜检查的结果同时结合病人症状将GERD分成3型,观察病人在各型中的分布。结果:食管内24h胆红素与pH监测结果显示:Ⅰ、Ⅱ型病人胆红素吸收值≥0.14及pH<4总时间百分比、酸反流次数和胆汁反流次数较对照组和Ⅲ型明显增加(P<0.05),而Ⅰ型和Ⅱ型之间无显著性差异(P>0.05),Ⅲ型和对照组之间无显著性差异(P>0.05)。GERD病人在3个临床分型中呈正态分布。Ⅰ、Ⅱ、Ⅲ型病人分别为23.3％、65.9％、10.8％。结论:临床上对GERD分型有助于进一步探讨和研究临床治疗。     

Study of Respiratory Disorders in Endoscopically Negative and Positive Gastroesophageal Reflux Disease

Background/Aim:

The relation between respiratory disorders and reflux symptoms has been debated since the beginning of the last century and the interest in this question has increased during the last few decades. This study aims to investigate the relation between specified respiratory disorders and reflux symptoms and examine the correlations between respiratory disorders and endoscopic findings in patients with gastroesophageal reflux disease.

Patients and Methods:

This study included 515 patients evaluated for gastroesophageal reflux disease (GERD) by patient self-report symptom questionnaire; modified four grade Likert scale and endoscopic assessment using endoscopic Los Angeles Classification. All participants were asked about various respiratory symptoms experienced during the past six months and exposed to measuring body mass index (BMI), medical history, pulmonary physical examination, chest X-ray, respiratory function tests and available sleep studies.

Results:

A total number of 515 patients were categorized according to endoscopic findings into two groups; (group1) subjects with normal endoscopic studies (NERD) 118 (22.9%) patients and (group2) subjects with abnormal endoscopic studies (ERD) 397 (77.1%). The proportion of females was significantly higher in ERD group (80.1%) as compared with NERD group (62.7%) (P<0.02). Duration of reflux symptoms found to be significantly prolonged in ERD group (P<0.03). The cases of ERD group were more likely to be overweight (BMI > 25) P<0.02. History of pulmonary symptoms preceding GERD symptoms was found in 15% of patients. There were 294 patients (57.1%) with different pulmonary manifestations. These manifestations were significantly higher among female group (P<0.01) and among obese, above 40 years old (P<0.001, 0.05 respectively). Among all patients with respiratory manifestations the commonest disorders diagnosed were chronic pharyngitis (50.3%), chronic bronchitis (15.8%), bronchial asthma (12.6%) and recurrent pneumonia (3.3%). Obstructive sleep apnea and recurrent hemoptysis were present in 2.7% and 1.5% of the studied patients respectively. There were three cases of chronic lung abscess. There was a significant difference between ERD and NERD groups in their relations to respiratory disorders (P<0.001). There were statistically significant differences in FEV1, FVC and FEV1/FVC (P<0.02, P<0.05 and P<0.05) respectively in ERD group as compared with NERD group.

Conclusion:

The study confirms the strong link between gastroesophageal reflux symptoms and various respiratory disorders. Endoscopy of the upper digestive tract remains an important exam in the evaluation of GERD. Respiratory symptoms are more prevalent among erosive esophagitis patients with a positive correlation with degree of severity. There is direct relationship between the severity of airways obstruction as detected by FEV₁ and FEV1/FVC and GER symptoms.     

One-week Esomeprazole Treatment: an Effective Confirmatory Test in Patients with Suspected Gastroesophageal Reflux Disease

Background: Symptomatic response to acid inhibition can be used as a guide in diagnosing patients with reflux symptoms. The proton-pump inhibitor (PPI) omeprazole has been used as such a diagnostic tool. Intragastric acid control with esomeprazole is more effective than other PPIs and has the potential to offer an advance in the diagnostic use of PPIs. Methods: Patients experiencing heartburn (for ≥6 months) were studied in this randomized, double-blind, multicenter study. Following a 3-day placebo run-in, 440 patients were randomized to 14 days' treatment with esomeprazole 40 mg once daily (o.d.), esomeprazole 20 mg twice daily (b.i.d.) or placebo. Heartburn symptoms were recorded daily. Endoscopy and 24-h esophageal pH-monitoring were performed to determine the presence of gastroesophageal reflux disease (GERD). The esomeprazole treatment test was considered positive if patients' symptoms improved during the treatment period compared with symptoms recorded on Day 0. Results: 63 patients were excluded from the analysis due to lack of symptoms on Day 0 or failure to complete pH-monitoring. The sensitivity of an esomeprazole treatment test in confirming GERD increased during the first days of treatment and stabilized between 79% and 86% after 5 days (both esomeprazole arms). The corresponding figure for the placebo arm was 36%. Specificity was variable (24%-65%) for both active treatment and placebo. Conclusion: A treatment test with esomeprazole 40 mg has a high sensitivity in confirming GERD. Furthermore, the data indicate that 1-week treatment with a once-daily dosage is sufficient to ensure adequate diagnosis.     

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...     

胃食管反流病患者的行为干预治疗

背景:胃食管反流病(GERD)为临床常见病,部分患者药物治疗效果不佳。不良生活方式和饮食习惯可影响GERD的发病,目前关于药物联合行为干预治疗GERD的研究报道尚少。目的:评估行为干预辅助治疗GERD患者胃食管反流症状的临床疗效。方法:120例GERD患者随机分为2组,研究组予埃索美拉唑20mg bid联合行为干预治疗,对照组仅予埃索美拉唑,疗程均为8周。治疗期间记录烧心、反酸、胸痛症状并分级,根据症状总体改善情况评估临床疗效。结果:研究组59例、对照组58例患者完成治疗方案。治疗8周末,研究组显效率和总有效率分别为76.3%和91.5%,对照组分别为58.6%和77.6%,组间差异有统计学意义(P0.05)。结论:埃索美拉唑联合行为干预对GERD患者的胃食管反流症状有明显疗效。