奥美拉唑、泮托拉唑、兰索拉唑和埃索美拉唑对反流性食管炎患者症状缓解的比较研究

目的比较奥美拉唑、泮托拉唑、兰索拉唑和埃索美拉唑对反流性食管炎患者症状缓解之间的差异。方法320例内镜诊断为反流性食管炎患者被随机分为4组，并分别服用奥美拉唑20mg，1次／d，8周；兰索拉唑30mg，1次／d，8周；泮托拉唑40mg，1次／d，8周；埃索美拉唑40mg，1次／d，8周。用six—point scale（0：无，1：轻度，2：轻度-中度，3：中度，4：中度-重度，5：重度）评价服用4种质子泵抑制剂后7天内的烧心和反流症状。结果埃索美拉唑组的平均烧心积分比其他质子泵抑制剂下降更迅速。埃索美拉唑组第1～5天的烧心症状完全消失率明显高于奥美拉唑组（P值分别为0．0054、0．0072、0．0089、0．0107、0．0134）、兰索拉唑组（P值分别为0．0043、0．0034、0．0044、0．0011、0．0052）、泮托拉唑组（P值分别为0．0156、0．0003、0．0005、0，0024、0．0172）。内镜下反流性食管炎愈合率4组之间无明显差异。结论埃索美拉唑比奥美拉唑、兰索拉唑、泮托拉唑更迅速地减轻反流性食管炎患者的烧心和反流症状。

Comparative study of omeprazole, pantoprazole, lansoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

Objective To clarify whether there is any difference in symptom relief in patients with reflux esophagitis administrating omeprazole, pantoprazole, lansoprazole, esomeprazole. Methods Three hundred and twenty patients with reflux esophagitis were randomly divided to receive 8 weeks of 20 mg omeprazole, 40 mg pantoprazole, 30 mg lansoprazole, 40 mg esomeprazole once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 days of administration were assessed using a six-point scale （0 ： none, 1 ： mild, 2 ： mild-moderate, 3 ： moderate, 4 ： moderate-severe, 5 ： severe）. Results The mean heartburn scores in patients administrating esomeprazole decreased more rapidly than that in patients administrating other PPIs. Complete resolution of heartburn was also more rapidly in patients treated with esomeprazole for 5 days compared with omeprazole （P = 0. 0054, 0. 0072, 0. 0089, 0. 0107, 0.0134, respectively） , lansoprazole （P = 0. 0043, 0. 0034, 0. 0044, 0. 0011, 0. 0052, respectively） , and pantoprazole （P =0. 0156, 0. 0003, 0. 0005, 0. 0024, 0. 0172, respectively）. There was no significant difference in endoscopic healing rate of reflux esophagitis at 8 weeks among the four groups. Conclusion Esomeprazole may relief heartburn and reflux symptoms faster than omeprazole, pantoprazole and lansoprazole in patients with reflux esophagitis.