摘要
目的以24 h食管pH监测为客观指标,结合临床症状及内镜观察,综合评价奥美拉唑和莫沙必利治疗反流性食管炎的疗效和应用范围。方法选取2002年1月~2005年12月间安阳钢铁公司职工总医院经内镜观察确诊的72例反流性食管炎患者,随机分为3组,即联合用药组(24例)、奥美拉唑组(24例)、莫沙必利组(24例),进行治疗观察。联合用药组:应用奥美拉唑20 mg,晨服1次,莫沙必利每次5 mg,每日3次于餐前半小时口服;奥美拉唑组:奥美拉唑20 mg,晨服1次;莫沙必利组:莫沙必利每次5 mg,每日3次于餐前半小时口服。疗程均为4周,观察指标包括烧心、胸痛、反酸、打嗝等临床症状,以及24 h食管pH检测数据和治疗4周后胃镜复查结果。结果联合用药组和奥美拉唑组以及莫沙必利组2周末症状控制率分别为83.33%、70.83%和54.17%(P<0.05);4周末分别为95.83%、91.67%和79.17%(P<0.05);4周末内镜观察有效率分别为95.83%、83.33%和62.50%(P<0.05);食管pH监测数据均有改善,奥美拉唑组和莫沙必利组相似,对于Ⅱ~Ⅳ级食管炎,内镜观察以及pH监测数据明显改善,奥美拉唑组优于莫沙必利组,但疗效均不及联合用药组。结论奥美拉唑、莫沙必利对反流性食管炎疗效良好,治疗Ⅱ级以上反流性食管炎,奥美拉唑单独使用疗效优于莫沙必利,但疗效均不及奥美拉唑和莫沙必利联合使用,表明对反流性食管炎进行分级治疗和个体化治疗是合理的,且具有一定实际意义。
Objective In order to contrast the therapeutic outcome of omeprazole and mosapride treating reflux esophagitis and to summarize and evaluate the curative effects and applicable scope of the two,24-hours esophageal pH monitoring combined with clinical symptom and endoscopic observation was used.Methods 72 patients with reflux esophagitis identified and dignosed by endoscopic were collected in Hospital of Anyang Iron & Steel Group from Jan.2002 to Dec.2005.The patients were divided into three groups randomly: associated-dose group(24 cases)/ omeprazole group(24 cases)/ mosapride group(24 cases),observing their corresponding therapuatic effects.Associated-dose group: treated with omeprazole 20mg qd every morning,and mosapride 5mg tid,30 minutes before every meal;omeprazole group: treated with omeprazole 20mg qd every morning;mosapride group: treated with mosapride 5mg tid,30 minutes before every meal.The period of treatment was 4 weeks,observed markers such as pyrosis,spontaneous esophageal chest pain,regurgitation,acid reflux,belching clinical symptom,dysphagia,the detect data for the pH of esophagus in 24-hours esophageal pH monitoring,and countercheck endoscopic results for 4 weeks after treatment were taken as criteria for comparison.Results The symptom control rates in associated-dose group,omeprazole group and mosapride group for 2 weeks after treatment were 83.33%,70.83% and 54.17%,respectively(P<0.05);for 4 weeks after treatment were 95.83%,91.67% and 79.17%,respectively(P<0.05);the endoscopic efficiency was 95.83%,83.33% and 62.50%,respectively(P<0.05);the data for pH detect in esophagus were improved.Those in omeprazole group were similar with that in mosapride group.However,for the group with grade Ⅱ~Ⅳ esophagitis,the endoscopic effects and the improvement for pH detect in omeprazole group were better than those in mosapride group,but the therapeutic effects in omeprazole group and mosapride group were not as good as those in associated-dose group.Conclusion Omeprazole and mosapride have good theraputic efftcts for reflux esophagitis.For the reflux esophagitis above grade Ⅱ,treating patients with only omeprazole is better than mosapride,but both of their therapeutic effiency are not as good as those treated by combining omeprazole with mosapride.Above all,the research shows that it is very reasonable and meaningful to treat reflux esophagitis corresponding their grades.
出处
《河南职工医学院学报》
2007年第3期212-216,共5页
Journal of Henan Medical College For Staff and Workers