埃索美拉唑治疗裂孔疝并发食管炎的临床观察

目的探讨埃索美拉唑对食管裂孔疝并发的反流性食管炎的临床疗效。方法将98例经内窥镜证实食管裂孔疝并发反流性食管炎的患者随机分为两组,A组50例,给予埃索美拉唑20mg,2次/d;B组48例,给予奥美拉唑20mg,2次/d;两组疗程均为8周,均同时加用促动力剂伊托比利及黏膜保护剂铝镁加混悬液。分别于治疗2,4,6,8周后记录烧心、反酸和胸骨后疼痛等症状记分,判断疗效,并于8周后复查胃镜,观察胃镜下食管炎愈合率。结果治疗8周后,上述3种主要症状总体疗效为：A组显效率为82.0%（41/50）,总有效率为94.0%（47/50）;B组显效率为64.6%（31/48）,总有效率为85.4%（41/48）,两组比较差异有统计学意义（P〈0.05）。两组在内镜下食管炎愈合率、总有效率方面差异存在统计学意义（P〈0.05）。结论埃索美拉唑是治疗食管裂孔疝并发的反流性食管炎的有效药物。

Clinical Observation of Esomeprazole for Reflux Esophagitis Complicated by Esophageal Hiatal Hernia

Objective To investigate the clinical efficacy of esomeprazole on reflux esophagitis（RE） complicated by the esophageal hiatal hernia.Methods Ninety eight cases of esophageal hiatal hernia with reflux esophagitis patients confirmed by endoscope were randomly divided into 2 groups.50 cases in group A were given esomeprazole 20 mg,Bid;48 cases in group B were given esomeprazole 20 mg,Bid.The prokinetic agent Billy Ito and mucosal protective agent Almagate suspension were used in both groups concurrently.The course was 8 weeks.The symptoms such as heartburn,acid reflux and retrosternal pain points were recorded to determine the efficacy at 2nd,4th,6th and 8th week,and the endoscopy was reviewed to observed the healing rate of esophagitis at 8th week.Results After the treatment of 8 weeks,the apparent rate was 82.0% in group A and 64.6% in group B respectively,the total effective rate was 94.0%（47/50） in group A and 85.4%（41/48） in group B respectively.The difference in endoscopic healing rate of esophagitis and total effective rate between the two groups had statistical significance（P0.05）.Conclusion Esomeprazole is an effective drug in the treatment of reflux esophagitis complicated by esophageal hiatal hernia.