枸橼酸铋雷尼替丁治疗反流性食管炎的疗效和安全性

目的：评价枸橼酸铋雷尼替丁对反流性食管炎的临床疗效及安全性。方法：将121例LA分级为A～D级的反流性食管炎患者随机分为3组，实际完成107例，试验组（n=38）予枸橼酸铋雷尼替丁350mg，po，bid；对照1组（n=36）予奥美拉唑40mg，po，qd；对照2组（n=33）予多潘立酮10mg，po，tid。疗程均为4周，根据临床症状及胃镜复查评价疗效。结果：内镜下病变改善情况试验组治愈率为65.79％，总有效率为92.11％；对照1组治愈率为75.00％，总有效率为91.67％；对照2组治愈率为51.52％，总有效率为78.79％。治愈率和总有效率试验组与对照1组比较差异无显著性（P〉0.05），但均明显高于对照2组（P〈0.05）。三组均未出现明显不良反应。结论：枸橼酸铋雷尼替丁治疗轻、中度反流性食管炎有效，与经典的质子泵抑制剂治疗方法相比疗效相当，优于单用促动力药多潘立酮。

Clinical evaluation of three therapeutic regimens for reflux esophagitis

Objective:To compare the efficacy of ranitidine bismuth citrate (RBC) to other two therapeutic regimens in the treatment of the reflux esophagitis. Methods:121 patients with reflux esophagitis (Los Angles classification A to D grade) were randomly assigned into one of 3 treatment groups: RBC (350 mg, bid) , omeprazole (40 mg, qd) and domperidone (10 mg, tid) for 4 weeks. The efficacy was evaluated based on the improvement of reflux esophagitis by endoscopy. Results:The healing rate in three therapeutic regimens was 65.79% , 75.00% and 51.52% , respectively. The total improvement rate was 92. 11% , 91. 67% and 78. 79% , respectively. No significant differences of the healing rate and total improvement rate were found between the RBC group and omeprazole group. Compared to the domperidone-treated patients, the healing rate and total improvement rate in both RBC and omeprazole showed significant differences. Patients were well tolerated. Conclusion:RBC and omeprazole provided better therapeutic options in the treatment of reflux esophagitis than domperidone.