雷贝拉唑与奥美拉唑治疗老年反流性食管炎的内镜疗效对比

目的：以内镜检查对比评价雷贝拉唑与奥美拉唑治疗老年反流行食管炎的临床疗效,并分析不同内镜分级下成本-效果比,以指导临床治疗。方法：选取本院收治的96例老年反流性食管炎患者为研究对象,随机分为A组与B组,在西沙必利10mg,3次/d的基础上,分别给予雷贝拉唑10mg,1次/d或奥美拉唑20mg,2次/d。对比两组胃镜下炎症愈合情况;按基础胃镜征象将患者划分为轻度患者（内镜分级A~B级）和重度患者（内镜分级C~D级）,对比两组在不同药物治疗下疗效及成本-效果比。结果：内镜检查整体对比：观察组治疗第1周、第4周后总有效率明显优于对照组,差异有统计学意义（P〈0.05）;至第八周总有效率均达到97.9%。重度患者对比：A组成本-效果及敏感度分析下C/E及ΔC/ΔE均优于B组。轻度患者对比：A组成本-效果及敏感度分析下C/E及ΔC/ΔE均差于B组。结论：雷贝拉唑治疗老年反流性食管炎疗效好、见效快,但对内镜诊断为A~B级患者,改行奥美拉唑成本-效果比更佳,更适合经济困难患者。

Endoscopy curative effect analysis of rabeprazole and omeprazole to treat reflux esophagitis in old patients

Objective： To compare the clinical curative effect of reflux esophagitis between abeprazole and omeprazole under endoscopy , and to analyze the cost-effectiveness ratio under different endoscopic grading. Methods： A total of 96 cases of reflux esophagitis old patients were enrolled and randomly divided into group A and group B with number table method , on the basis of 10 mg, 3 times/d of xisha. The two groups were given rabeprazole azole 10 mg, 1 / d and omeprazole 20 mg, 2 times/d, respectively.. Compared inflammation healing status of both groups under gastroscope. Base on gastroseope signs, patients were categorized as mild cases patients with endoscopic （class A and B） and severe patients （endoscopic class C ~ D）. Compared two groups under different drug treatment efficacy and cost-effectiveness ratio. Results： Endoscopic results showed therapeutic effects of the observation group 1 and 4 weeks after treatment were all better than that of the control group （P〈 0.05）. Till 8 weeks after treatment, the effective rate was 85.4%. For sever patients, the cost-effectiveness ratio of group A were all better than that of the control group including C/E and △C/△E （P〈0.05）. While for mild patients, C/E and △C/△Eof group A was worse than that of group B. Conclusion; Rabeprazole shows good and quick effects on reflux esophagitis in old patients, but for grad A-B patients, omeprazole shows better eost-effectiveness.