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1、[经典]雷贝拉呼联合莫沙必利治疗反流性食管炎疗效观察雷贝拉呻联合莫沙必利治疗反流性食管炎疗效观察【摘要】目的探讨雷贝拉I坐联合莫沙必利治疗反流性食管炎(refluxesophagitis,RE)的临床疗效和安全性。方法将120例经胃镜证实的反流性食管炎患者随机分成治疗组和对照组。治疗组60例:口服雷贝拉卩坐10mg,1次/d,莫沙必利5mg,3次/d;对照组60例:口服奥美拉哇20mg,2次/d,莫沙必利5mg,3次/d。疗程均为6周,疗程结束后复查胃镜,观察镜下愈合率,并记录症状改善情况及不良反应。结果治疗1周后,治疗组和对照组临床症状改善总有效率分别为75%
2、,46.7%,两组比较有显著性差异(P<0.01);6周后,治疗组和对照组临床症状改善总有效率、胃镜下有效率分别为95%,90%、93.3%,90%0两组差异均无统计学意义(P>0.05)o结论雷贝拉哩联合莫沙必利治疗反流性食管炎症状改善迅速,病变愈合率和症状改善率高,是治疗反流性食管炎安全、有效、理想的药物。【关键词】雷贝拉卩坐;莫沙必利;反流性食管炎ClinicalefficacyofrabeprazolecombinedwithmosaprideinthetreatmentofrefluxesophagitisYINKai-qin,ZHANGHan-don
3、g.People'sHospitalofYinanCounty,Shangdong276300,China[Abstract]ObjectiveToinvestigatetheefficacyandsafetyofrabeprazoleandmosaprideinthetreatmentofrefluxesophagitis・Methods120patientswithrefluxesophagitisprovenbyendoscopewererandomlydividedintotwogroups:Thetreatmentgroup(n二60)received
4、rabeprazole10mgoncedailyandmosapride5mgthreetimesdaily;Thecontrolgroup(门二60)receivedomeprazole20mgtwicedailyandmosapride5mgthreetimesdaily.After6weeks,endoscopywasperformedtostudythehealingrate,Improvementinsymptomsandadverseeffectswererecorded.ResultsAfter1week,thetotalsymptomimprov
5、ementratesinthetreatmentgroupandthecontrolgroupwere75%,46.7%,Thereweresignificantdifferencesbetweenthetwogroups(P<0.01);After6weeks,thetotalsymptomimprovementratesandtheendoscopichealingrateswere95%,90%>93.3%,90%respectively,Therewerenostatisticallysignificantdifferencesbetweenthetwo
6、groups(P>0.05).ConclusionRabeprazolecombinedwithmosapridecanrapidlyimprovethesymptomofREandissafeandeffectiveinthetreatmentofrefluxesophagitis・[Keywords]Rabeprazole;Mosapride;Refluxesophagitis反流性食管炎是消化系统的常见病,主要是胃和十二指肠内容物,特别是酸性胃液或胃液与胆汁反流至食管而引起的食管黏膜炎症、糜烂、溃疡而形成。其治疗原则是减少胃食管反流,降低反流液的酸度,增强
7、食管清除力和保护食管黏膜。药物治疗以抑酸及促进胃排空为主。雷贝拉呼是新一代质子泵抑制剂,抑酸作用强大而持久。莫沙必利也是新一代促胃动力药。本研究将两药联合治疗反流性食管炎以观察疗效,并与奥美拉呼联合莫沙必利进行对比,现将结果报告如下。1对象与方法1.1病例选择经胃镜证实为反流性食管炎患者120例,其中男78例,女42例,年龄21〜72岁,平均49岁,病程6个月〜5年,平均2.6年,均有反酸、烧心、胸骨后疼痛等胃食管反流症状,无其他消化系统疾病及可致胃肠道症状的全身性疾病,4周内无服用制酸药和促胃动力约物史。根据2003年全国反流性食管炎研讨会制定的内镜下食管黏膜
8、病变表现分级标准[1],