熊去氧胆酸在治疗胆汁反流性食管炎中的作用

目的 探讨熊去氧胆酸治疗胆汁反流性食管炎的疗效。方法 将186例患者随机分为3组：A组应用奥美拉唑20mg，2次／d；多潘立酮10mg，3次／d；治疗4周。B组应用熊去氧胆酸0．25g，2次／d；多潘立酮10mg，3次R／d；治疗4周。C组应用多潘立酮10mg，3次／d，治疗4周。服药1、2、4周时随访，分别观察3组症状改善情况。治疗4周后复查内镜、24h食管pH及胆汁监测。结果 A组与B组患者治疗后1、4周症状积分即显著降低（P〈0．01），C组治疗后症状积分也有降低（P〈0．05）。内镜检查：A组治愈率74．2％，有效率96．8％；B组治愈率71．0％，有效率91．9％；C组治愈率46．8％，有效率53．2％。A组、B组及C组治疗后24h食管酸暴露情况均显著改善，但A组在改善酸反流方面更明显（P〈0．01）；A组、B组治疗后食管胆汁反流均有显著改善，B组改善更明显（P〈0．01），C组对胆汁反流的改善不显著（P〉0．05）。结论 熊去氧胆酸联合应用质子泵抑制剂及促动力药治疗胆汁反流性食管炎疗效显著。

Ursodeoxycholic acid in treatment of bile reflux esophagitis

Objective To investigate the therapeutic effect of ursodeoxycholic acid on bile reflux esophagitis.Methods 186 patients with bile reflux esophagitis were randomly divided into three groups.Group A was treated with 20 mg omeprazole twice a day and 10 mg domperidone three times a day for 4 weeks.Group B was treated with 0.25 g ursodeoxycholic acid twice a day and 10mg domperidone three times a day for 4 weeks.Group C was treated with 10 mg domperidone three times a day for 4 weeks.One-week,two-week and four-week follow up were conducted to observe the improvement of the symptoms in three groups.24 h intraesophageal pH/bile monitoring and endoscopy were reconducted 4 weeks after administration.Results The symptom score in group A and group B were significantly decreased 1 week and 4 week after treatment (P<0.01) and the symptom score in group C was slightly decreased (P<0.05).The healing rate and effective rate were 74.2% and 96.8%,71.0% and 91.9%,46.8% and 53.2% respectively in group A,group B and group C.24h intraesophageal pH/bile was significantly improved in the three groups but the improvement of acid reflux was more obvious in group A (P<0.01).Bile reflux was obviously improved in group A and group B after treatment with more obvious in group B (P<0.01) but the bile reflux was not significantly improved in group C (P>0.05).Conclusion Combination of Ursodeoxycholic acid and proton pump inhibitor as well as dynamics-promoting medicine is effective in treating bile reflux esophagitis.