奥美拉唑和替加色罗治疗非糜烂性反流病的疗效分析

目的研究奥美拉唑和替加色罗对非糜烂性反流病(NERD)的治疗效果。方法对2005年5月至2006年3月上海交通大学医学院附属瑞金医院收治的83例NERD患者进行临床症状评分并行24h食管pH及24h食管胆汁反流监测。根据检查结果分为单纯酸反流组(25例)、单纯胆汁反流组(6例)、混合反流组(13例)和无反流组(39例)。每组患者给予奥美拉唑或替加色罗治疗2周。结果经奥美拉唑或替加色罗治疗2周后,单纯酸反流组、混合反流组及无反流组临床症状与治疗前相比均明显改善(P均<0.01)。奥美拉唑治疗前后,单纯酸反流组和混合反流组食管pH改变有显著性意义(P均<0.05),而混合反流组食管胆汁反流改变无显著性意义(P>0.05)。替加色罗治疗前后,单纯酸反流组食管pH改变无显著性意义(P>0.05);混合反流组食管pH和胆汁反流改变均无显著性意义(P均>0.05)。结论奥美拉唑和替加色罗治疗可显著改善NERD患者的症状。奥美拉唑可改善NERD患者酸反流,但不能改善胆汁反流。替加色罗不能有效改善NERD患者酸反流及胆汁反流。

Analysis of the effect of omeprazole and tegaserod on non-erosive reflux disease

Objective To investigate the incidence of isolated acid reflux,isolated bile reflux,mixed reflux and no reflux in patients with non-erosive reflux disease and to evaluate the efficacy of Omeprazole(Losec)and Tegaserod(Zelmac)in treatment of NERD.Methods Eighty-three NERD patients were asked to complete the reflux disease questionnaire(RDQ)factually for symptom evaluation.Simultaneous 24-hour esophageal pH and Bilitec 2000 bile monitoring were performed in all NERD patients.According to the results,the patients were randomized to take Losec 20mg qd or Zelmac 6mg bid for 2 weeks.Results Both Omeprazole and Tegaserod therapy greatly improved the reflux symptoms of the patients with isolated acid reflux,mixed reflux and no reflux(P<0.01).Omeprazole decrease the abnormal acid exposure in NERD patients with isolated acid reflux and with mixed reflux(P<0.05),but did not decrease the abnormal bile exposure in NERD patients with mixed reflux(P>0.05).Tegaserod decreased neither the abnormal acid exposure in NERD patients with isolated acid reflux and with mixed reflux(P>0.05),nor the abnormal bile exposure in NERD patients with mixed reflux(P>0.05).Conclusion Omeprazole and Tegaserod improved the reflux symptoms of the NERD patients.Omeprazole improves abnormal acid exposure but not abnormal bile exposure.Tegaserod improved neither abnormal acid exposure nor abnormal bile exposure.