反流性食管炎患者的症状特征及雷贝拉唑治疗疗效的多中心评估

Characters of symptoms in patients with reflux esophagitis and evaluation of efficacy of rabeprazole:A multi-center study

目的观察不同程度反流性食管炎(RE)的反流症状特点和对雷贝拉唑8周治疗的疗效。方法多中心、随机、开放研究。78例经内镜确诊的RE患者,按洛杉矶分级标准(LA)分为A、B、C、D组。患者口服雷贝拉唑10mg,每天2次,共8周。观察不同程度RE患者的反流症状特征以及雷贝拉唑治疗后症状变化和8周后RE治愈率。结果74例RE患者完成8周疗程。91.9%患者有烧心和反酸,68.9%有胸骨后疼痛。反酸、烧心和胸骨后疼痛发作程度和频率并不随RE程度或频度加重而增加。A+B组和C+D组RE患者的反酸和烧心程度和频度均以中、重度为著,两组间差异无统计学意义(P>0.05)。胸骨后疼痛在不同程度RE患者中发作程度和频率之间差异无统计学意义(P<0.05)。用药第1天,烧心、反酸、胸骨后疼痛症状的消失率和缓解率分别为26.5%、42.6%、47.6%和51.5%、64.7%、68.7%,用药1周后各反流症状消失率和缓解率可高达50%以上和80%以上。8周治疗后复查RE愈合率为94.6%(70/74)。结论RE患者的症状不因RE程度加重而增加,雷贝拉唑对RE患者的反流症状和RE显示有效和疗效迅速。

Objective To observe the characteristic of reflux symptoms in patients with different severity of reflux esophagitis(RE) and evaluate the effect of rabeprazole treatment on RE. Methods A multicenter, randomized study was performed in 4 medical centers. Seventy-eight patients with endo-scopically confirmed RE were enrolled, and rabeprazole, 10 mg bid was given for 8 weeks. Patients with RE were classified into A+B and C+D groups according to LA classification. The disappearance rate, remission rate of reflux symptoms and healing rate of RE were assessed after treatment. Results Seventy-four patients with RE completed 8 weeks treatment. At the baseline, 91.9% of patients pre-sented heartburn and acid regurgitaion, 68.9% with chest pain. The severity and frequency of reflux symptoms were shown not to be consistent with severity of RE. And there were no significant difference of symptoms between A+B and C+D groups. Disappearance rate and remission rate of heartburn, acid regurgitaion and chest pain after one day treatment were 26.5%, 42.6%, 47.6% and 51.5%, 64.7%, 68.7%, respectively, and over 50% and 80% after 7 days of treatment. The healing rate of RE at the end of 8 week was 94.6%. Conclusions The study showed symptoms of RE was not necessarily con-sistent with severity of RE. Rabeprazole had fast effect on relief of reflux symptoms and high healing rate of RE.