西沙必利与雷尼替丁联合应用治疗反流性食管炎的临床观察

对１２１例反流性食管炎的患者给予西沙必利和雷尼替丁治疗，以单独应用西沙必利或雷尼替丁为对照，结果表明，联合应用西沙必利和雷尼替丁比单独使用两种药物疗效显著（Ｐ〈０．０１），而单独应用西沙必利和雷尼替丁二者之间治疗反流性食管炎疗效无差异（Ｐ〉０．０５）。     

西少必利治疗婴幼儿胃食管反流分析

目的：评价西沙必利治疗婴幼儿胃食管反流（ＧＥＲ）的疗效。方法：将８０例ＧＥＲ病儿随机分为２组,Ｂ组为西沙必利治疗组,Ｃ组为体位治疗组,取２０例无症状儿为对照组（Ａ组）,观察指标取症状恢复时间,食管ｐＨ值,ＬＥＳＰ检测变化。结果：西沙必利ＧＥＲ疗效确实。Ｂ组总有效率（９０．０％）与Ｃ组（６０．０％）比较有显著性差异（Ｐ〈０．０１）。结论：西沙必利治疗ＧＥＲ确实有效,并无明显副作用。     

奥美拉唑治疗胃食管反流病临床疗效观察

目的探讨奥美拉唑治疗胃食管反流病的临床效果。方法选取我院2011年5月至2012年6月胃食管反流患者60例,随机分为两组,各30例,对照组采用雷尼替丁治疗,观察组采用奥美拉唑治疗,经过治疗后对两组临床效果进行比较。结果对照组治疗有效率81.13%,观察组临床有效率达到96.77%,两组比较差异明显,有统计学意义（P〈0.05）。结论奥美拉唑治疗胃食管反流病,疗效显著,值得推广。     

奥美拉唑联合西沙必利治疗胃食管反流病临床观察

目的评价奥美拉唑联合西沙必利治疗胃食管反流病的临床效果。方法将65例胃食管反流病患者随机分为观察组33例和对照组32例,对照组给予西沙比利治疗,观察组给予奥美拉唑联合西沙比利治疗,疗程均为4周。比较2组临床疗效、复发率和不良反应。结果观察组总有效率为84.8%高于对照组的68.7%,复发率低于对照组,差异均有统计学意义（P〈0.05）。结论奥美拉唑联合西沙必利治疗胃食管反流病可提高总有效率,降低复发率,不良反应少,能最大限度减少反流的发生,减轻胃酸对食管黏膜的损伤,促进黏膜尽快修复。     

莫沙必利联合埃索美拉唑对胃食管反流患者胃食管动力学及胃电活动指标的影响研究

目的：研究莫沙必利联合埃索美拉唑对胃食管反流患者胃食管动力学及胃电活动指标的影响。方法选取2012年1月∽2013年12月本院收治的胃食管反流患者110例,根据不同治疗方式分为对照组和观察组各55例,对照组采用埃索美拉唑组治疗,观察组在对照组治疗的基础上给予莫沙必利,分析比较两组患者治疗后3、6、12周的胃食管动力学及胃电参数。结果治疗后3、6、12周,观察组胃动力学指标（胃窦收缩幅度、胃窦运动指数及胃窦收缩频率）、食管动力学指标（食管括〈肌压力、食管括〈肌松弛率及蠕动性收缩比）及胃电活动指标（餐前及餐后的频率及幅值）均显著高于对照组（P〈0.05）,且观察组治疗后胃食管动力学指标及胃电参数呈进行性升高（P〈0.05）。结论莫沙必利联合埃索美拉唑对胃食管反流患者的胃食管动力学及胃电活动指标的影响较大,治疗效果较好。     

依托必利治疗胃食管反流病疗效观察

目的观察依托必利治疗胃食管反流病的疗效。方法选102胃食管反流病患者随机分为三组,治疗组42例（依托必利）对照组A40例（西沙必利）与对照组B42例（多潘立酮）,治疗8周。结果治疗组有效率97．62％,对照组A有效率达95．95％,对照组B78．57％治疗组优于对照组B（P〈0．01）。结论依托必利治疗胃食管反流病临床疗效好。     

雷贝拉唑与雷尼替丁治疗胃食管反流病疗效分析

目的研究雷贝拉唑与雷尼替丁对胃食管反流病（GERD）治疗效果。方法100例患者按食管胃反流病分类随机分雷贝拉唑（PPI）组与雷尼替丁（H2RA）组治疗,进行疗效对照分析。结果雷贝拉唑治疗胃食管反流病的症状缓解率、消失率、治愈率均高于雷尼替丁。结论雷贝拉唑与雷尼替丁对GERD均有效,但PPI优于H2RA。     

西沙必利对儿童胃食管反流合并轻至中度营养不良的疗效

目的探讨西沙必利对儿童胃食管反流合并轻至中度营养不良的疗效。方法选择我院100例2017年1月至2018年5月儿童胃食管反流合并轻至中度营养不良患儿。随机分组,对照组采取常规方法治疗,观察组则采取常规方法 +西沙必利治疗。比较两组儿童胃食管反流合并轻至中度营养不良疗效;胃食管反流症状消失时间、营养不良纠正时间;治疗前后患儿营养状态、炎症指标;不良作用。结果观察组儿童胃食管反流合并轻至中度营养不良疗效、胃食管反流症状消失时间、营养不良纠正时间、营养状态、炎症指标相比较对照组更好,P <0.05。观察组和对照组不良作用相似,P> 0.05。结论常规方法 +西沙必利治疗儿童胃食管反流合并轻至中度营养不良效果好。     

兰索拉唑在两种老年胃食管反流病中的临床应用效果

目的：探讨兰索拉唑在两种老年胃食管反流病中的临床应用效果。方法80例老年胃食管反流病患者,随机分为观察组和对照组,每组40例。对照组为非糜烂性胃食管反流病,观察组为糜烂性食管炎患者。两组患者均给予兰索拉唑治疗,治疗后进行食管症状评分。结果观察组治疗前的食管症状评分和对照组治疗前的食管症状评分比较,差异无统计学意义（P〈0.05）。观察组和对照组治疗4、8周后的食管症状评分分别和本组治疗前的食管症状评分比较,差异有统计学意义（P＜0.05）。观察组治疗4、8周后的食管症状评分分别和对照组治疗4、8周后的食管症状评分比较,差异无统计学意义（P〈0.05）。结论兰索拉唑在老年糜烂性食管炎和非糜烂性胃食管反流病均获得较好治疗效果,值得借鉴。     

洛赛克联合西沙必利治疗胃炎合并胃食管反流性疾病的临床研究

目的探讨洛赛克联合西沙必利治疗胃炎合并胃食管反流性疾病临床效果。方法选取我院自2015年5月至2017年5月期间收治的胃炎合并胃食管反流性疾病的患者共120例,采用随机数字表格法分为两组,每组60例,两组患者均给予胃炎与胃食管反流性疾病的对症药物治疗。对照组患者给予洛赛克(奥美拉唑肠溶胶囊)治疗,观察组给予洛赛克联合西沙必利治疗,对比临床疗效。结果经过4周的治疗,观察组患者临床总有效率为90%,对照组患者临床总有效率为75%,观察组显著高于对照组,差异有统计学意义(P<0.05)。结论洛赛克联合西沙必利治疗胃炎合并胃食管反流性疾病临床效果满意,值得在医院推广应用。     

Two different dose regimens of cisapride in the treatment of reflux oesophagitis: a double-blind comparison with ranitidine

We conducted a double-blind study comparing two dosage regimens of a prokinetic drug, cisapride (10 mg q.d.s. and 20 mg b.d.), with a low dose of a H₂ receptor antagonist (150 mg ranitidine b.d.) in the treatment of 155 patients with reflux oesophagitis as determined by endoscopy. The active treatment took 8 to 12 weeks depending on whether complete healing was found at endoscopy. Improvement in oesophagitis grades from baseline to endpoint was observed in 68% of patients in the 10 mg cisapride q.d.s. group, 83 % in the cisapride 20 mg b.d. group and 81% in the ranitidine group (N.S.). At endpoint, the percentages of endoscopically cured patients with initial grades I or II were 52% for 10 mg cisapride q.d.s., 71% for 20 mg cisapride b.d. and 80% for ranitidine (N.S.). The proportional improvement of the overall reflux symptom score (60%) also showed no significant difference between the three groups. In the treatment of mild reflux oesophagitis (grades I and II) similar results can be expected from 20 mg cisapride b.d. and 150 mg ranitidine b.d. As the results of the two dosage regimens of cisapride were not different, the 20 mg twice daily regimen is preferred because it will improve patient compliance. It is concluded that in reflux oesophagitis grades I and II, the efficacy of 20 mg cisapride b.d. and 150 mg ranitidine b.d. are broadly similar.     

Cisapride and ranitidine in the treatment of gastro-oesophageal reflux disease—a comparative randomized double-blind trial

Forty patients with gastro-oesophageal reflux disease and oesophagitis, documented by endoscopy (grades I to III by the Savary-Miller classification) were randomized to participate in a comparative doubleblind trial to receive cisapride (10 mg q.d.s.) or ranitidine (150 mg b.d.) for an 8-week period. Upper gastrointestinal endoscopy was performed immediately before the entry to the trial and after the 8-week period at the completion of the trial. The evaluable cohort included 37 patients who completed the trial, 18 in the cisapride group and 19 in the ranitidine group. Three patients were withdrawn from the trial; one on ranitidine developed severe anaphylactic reaction, one on cisapride severe dizziness and one on cisapride did not wish to continue on the trial. The results of the trial, regarding symptomatic and endoscopic improvement were comparable in the two groups. Both drugs were effective in controlling symptoms, such as acid regurgitation, retrosternal pain, retrosternal burning, epigastric fullness and discomfort (pain, burning, sense of pressure) and resulted in endoscopic healing of oesophagitis. With few exceptions, symptoms remained in remission 1 month after treatment in the majority of patients. Globally, both drugs were tolerated comparably, and adverse effects other than those which resulted in the withdrawal from the trial were minimal in both groups. The results of this trial indicate that cisapride and ranitidine, although of different pharmacological action, are comparable in their therapeutic effect in symptomatic improvement and endoscopic healing in patients with mild to moderate gastro-oesophageal reflux disease.     

Ranitidine, 75 mg, over-the-counter dose: pharmacokinetic and pharmacodynamic effects in children with symptoms of gastro-oesophageal reflux

BACKGROUND: The use of over-the-counter antacids has increased in children under the age of 12 years, and has been followed by an apparent increase in the use of over-the-counter histamine-2 receptor antagonists. However, the pharmacokinetic and pharmacodynamic effects of over-the-counter histamine-2 receptor antagonists in the paediatric population are largely unknown. AIM: To evaluate the pharmacokinetics and pharmacodynamics of a single dose of the over-the-counter histamine-2 receptor antagonist, ranitidine, 75 mg, in children with symptoms of gastro-oesophageal reflux disease. METHODS: Children aged between 4 and 11 years with symptoms of heartburn suspected to be due to gastro-oesophageal reflux disease were recruited at six clinical centres. Following a single dose of either oral ranitidine, 75 mg (n=19), or placebo (n=10), recording of intragastric pH and serial blood sampling were carried out for 6 h. RESULTS: The estimated pharmacokinetic parameters of ranitidine, 75 mg, were as follows: the median Cmax value of 477 ng/mL occurred within a median of 2.5 h after dosing, and the median half-life was 2.0 h. The intragastric pH began to rise approximately 30 min after dosing with ranitidine to a peak of pH; 4. The pH in the ranitidine group remained higher than that in the placebo group throughout the 6-h evaluation period. Adverse events were generally mild. CONCLUSIONS: Ranitidine, 75 mg, significantly increased the intragastric pH in children aged 4-11 years. The pharmacokinetic and pharmacodynamic profiles were similar to those in adults. Ranitidine, 75 mg, appears to be effective for the control of intragastric acidity for 5-6 h in children aged 4-11 years.     

Intragastric pH monitoring in acute upper gastrointestinal bleeding and the effect of intravenous cimetidine and ranitidine

Intragastric pH was measured continuously from 1800 to 1200 hours the following day in 22 duodenal ulcer patients and in eight gastric ulcer patients, all of whom had been admitted as emergencies with acute upper gastrointestinal haemorrhage. The effects of intravenous cimetidine or ranitidine were compared with no treatment. In patients with duodenal ulcer, median intragastric pH was 1.8 (range 1.0-4.9) in the group receiving no treatment. In the cimetidine group (400 mg, 6-hourly, n = 8) median pH was 4.7 (range 1.5-7.7) and after ranitidine (50 mg, 6-hourly, n = 10) it was 3.8 (range 1.2-7.8). The pH remained above 4.0 for 67% of the recording time with cimetidine, 47% with ranitidine and for only 3% with placebo. Intragastric pH in gastric ulcer patients without treatment was higher (median 3.4, range 1.0-6.9) than in duodenal ulcer patients with treatment. Both H2 antagonists raised intragastric pH in patients with gastric ulcer and maintained a gastric pH of greater than 4.0 for at least 50% of the time. Presently recommended i.v. doses of cimetidine and ranitidine do not consistently maintain gastric pH above 4.0 for long periods in patients with peptic ulcer bleeding.     

Management of endoscopy-negative reflux disease: progress with short-term treatment

The efficacy of omeprazole in the treatment of endoscopy-negative reflux disease has been examined in five recently completed, multicentre, double-blind, randomized, parallel group studies. A total of 1959 patients with endoscopy-negative reflux disease took part in these trials in which 20 mg omeprazole once daily (n = 722) was compared with placebo (n = 304) and/or 10 mg omeprazole once daily (n = 624), 150 mg ranitidine twice daily (n = 213), or 10 mg cisapride four times daily (n = 96). In all studies, the primary outcome measures were assessed after 4 weeks of treatment. Absence of heartburn, defined as no episodes of heartburn during the fourth week of treatment, occurred in 14–29% of patients receiving placebo, 31% receiving cisapride, 35% receiving ranitidine, 31–60% receiving 10 mg omeprazole once daily, and 44–62% receiving 20 mg omeprazole once daily. Adequate control of heartburn, defined as only 1 day with episodes of mild heartburn during the seventh week of treatment, occurred in 24% of patients receiving placebo. 46% receiving cisapride, 46% receiving ranitidine, 49–60% receiving 10 mg omeprazole once daily, and 56–63% receiving 20 mg omeprazole once daily, on the basis of data from three of the studies. The differences between the two omeprazole doses and placebo, and between 20 mg omeprazole once daily, and either 10 mg omeprazole once daily, ranitidine or cisapride, were all statistically significant (P < 0.05). Diary cards for most patients who responded to omeprazole showed an absence of heartburn in the first week of treatment. Health-related quality of life was measured at baseline and after 4 weeks of treatment, using validated questionnaires (i.e. the Psychological General Well-Being Index and the Gastrointestinal Symptom Rating Scale). After 4 weeks of treatment, the general well-being of patients taking 10 or 20 mg omeprazole once daily had improved significantly (P < 0.05) compared with those taking placebo. In conclusion, 10 and 20 mg omeprazole once daily provides effective and rapid control of heartburn in patients with endoscopy-negative reflux disease. Absence of heartburn and adequate control of heartburn occur significantly more frequently in patients treated with 20 mg omeprazole once daily, compared with patients treated with 10 mg omeprazole once daily, 150 mg ranitidine twice daily, or 10 mg cisapride four times daily. Omeprazole also restores health-related quality of life, in terms of enhanced well-being, to the level observed in a healthy population.     

西沙必利与多潘立酮分别联合奥美拉唑治疗反流性食管炎的疗效比较

目的评价西沙必利与多潘立酮分别联合奥美拉唑两种方法治疗反流性食管炎的疗效。方法将97例患者随机分为两组,其中观察组49例,对照组48例。观察组予奥美拉唑20mg,2次/d,西沙必利10mg,3次/d;对照组给予奥美拉唑20mg,2次/d,多潘立酮10mg,3次/d,两组维持治疗2个月,观察临床症状以及内镜复查结果。结果观察组治疗总有效率为98.0%,内镜检查有效率为95.9%;对照组临床治疗总有效率为87.5%,内镜检查有效率为83.3%,两组比较差异有统计学意义(P<0.05)。结论西沙必利联合奥美拉唑治疗反流性食管炎疗效优于多潘立酮联合奥美拉唑,值得在临床上推广。     

A comparative study of cisapride and ranitidine at controlling oesophageal acid exposure in erosive oesophagitis

Background: The severity of gastro-oesophageal reflux disease is generally considered to be related to the extent of oesophageal acid exposure. Current therapies include antisecretory and prokinetic agents. We compared two of these, ranitidine and cisapride, in their ability to lower oesophageal acid exposure in patients with erosive oesophagitis. Methods: Seven patients with Savary–Miller's grade II–IV oesophagitis and with oesophageal contact time ± 8% were studied. Mean lower oesophageal sphincter pressure was 4.6 mmHg. Oesophageal acid contact time was 25.6 ± 5.6%. Each patient received ranitidine 150 mg b.d., ranitidine 150 mg q.d.s., or cisapride 10 mg q.d.s. in a randomized 3-way cross-over design. Intra-oesophageal pH was monitored during 24 h for each of these treatments in a controlled hospital environment, while consuming a high fat, high calorie diet. Results: Cisapride and ranitidine at both doses decreased the acid contact time and the number of reflux episodes. However, a minority of patients treated with ranitidine, and none with cisapride, diminished their oesophageal acid contact time to a normal value of < 5%. No treatment significantly decreased nocturnal acid exposure. Conclusion: In patients with severe gastro-oesophageal reflux disease both cisapride and ranitidine demonstrably lower oesophageal acid exposure, but neither therapy predictably normalizes it.     

Clinical trial: the effects of adding ranitidine at night to twice daily omeprazole therapy on nocturnal acid breakthrough and acid reflux in patients with systemic sclerosis--a randomized controlled, cross-over trial

Background  Gastro-oesophageal reflux disease (GERD) is an important problem in systemic sclerosis due to impaired salivation and oesophageal function.
Aim  To determine the efficacy of adding ranitidine at bedtime to control nocturnal acid breakthrough (NAB) and GERD in patients with systemic sclerosis already prescribed high-dose omeprazole.
Methods  Patients with systemic sclerosis and GERD symptoms ( n  = 14) were treated with omeprazole 20 mg b.d. and either placebo or ranitidine 300 mg at bedtime for 6 weeks in a randomized, cross-over, placebo controlled study. At the end of each period a 24 h pH-study with intragastric and oesophageal pH measurement was performed.
Results  Pathological acid reflux occurred in eight patients with omeprazole/placebo and in seven with omeprazole/ranitidine ( P  = ns) with technically adequate oesophageal pH-studies ( n  = 13). NAB was present in eight patients with omeprazole/placebo and six with omeprazole/ranitidine ( P  = ns) in whom technically adequate gastric pH-studies were obtained ( n  = 10). The addition of ranitidine had no consistent effect on patient symptoms or quality of life.
Conclusion  Many patients with systemic sclerosis experienced NAB and pathological oesophageal acid exposure despite high-dose acid suppression with omeprazole b.d. Adding ranitidine at bedtime did not improve NAB, GERD or quality of life in this population.     

Circadian differences in pharmacological blockade of meal-stimulated gastric acid secretion

The effects of identical morning (08.05 hours) and evening (20.05 hours) meals on intragastric pH were compared in 12 healthy volunteers receiving gastric antisecretory medication. Dosing included continuous intravenous infusion ranitidine (50 mg bolus followed by 12.5 mg/h) or a matching placebo which were randomly administered prior to and following 7 days of treatment with oral omeprazole (40 mg mane). Intragastric pH was monitored continuously using a tethered indwelling pH probe. Subjects were divided into groups, one of which began the pH monitoring session in the morning, the other in the evening. The median 24-h intragastric pH was significantly increased by all active dosing regimens (P less than 0.05). Combined omeprazole and ranitidine produced the highest median pH, 5.92. However, a breakthrough drop in intragastric pH occurred during the evening after all active dosing. Intragastric pH fell prior to and after consumption of the evening meal with median pH values less than 4 during all sessions. The evening meal led to significantly lower intragastric pH compared to the morning meal for omeprazole and the combined omeprazole and ranitidine dosing periods (P less than 0.05). There was no difference between morning and evening pH during the placebo or ranitidine periods. Ranitidine and omeprazole, either alone or in combination, were unable to prevent the meal-stimulated decline in intragastric pH during the evening time period.     

埃索美拉唑联合西沙比利治疗老年反流性食管炎疗效分析

目的探讨老年反流性食管炎应用埃索美拉唑联合西沙比利治疗的疗效。方法选择2009年1月～2011年12月住院治疗的老年反流性食管炎患者63例随机分为观察组(n=32)与对照组(n=31)。对照组给予埃索美拉唑20mg口服,2次/d。观察组在对照组基础上再口服西沙比利10mg,3次/d。两组均治疗2个月后观察比较两组患者食管炎愈合情况及临床疗效。结果观察组内镜下食管炎愈合率为81.25%,对照组内镜下食管炎愈合率为64.52%,两组愈合率比较差异有统计学意义(P<0.05)。观察组显效21例,有效8例,无效3例,总有效率为90.63%;对照组显效15例,有效7例,无效9例,总有效率为70.97%,两组总有效率比较差异有统计学意义(P<0.05)。结论老年反流性食管炎应用埃索美拉唑联合西沙比利治疗疗效显著,是临床选择的理想药物。