质子泵抑制剂联合H_2受体拮抗剂治疗门脉高压性胃病

Treatment for portal hypertensive gastrpathy with proton pump inhibitor plus H2 receptor antagonist.

目的探讨质子泵抑制剂(PPI)联合H2受体拮抗剂(H2RA)在治疗门脉高压性胃病(PHG)中的作用。方法将46例肝硬化门脉高压性胃病患者随机分为治疗组和对照组,每组均给予奥美拉唑40mg静脉滴注1次/日×7日,心得安10mg口服3次/日。治疗组每晚加服雷尼替丁150mg。观察治疗后1周临床症状缓解率、1月后胃镜下胃黏膜改变、3月后患者再入院率。结果治疗组和对照组1周临床症状缓解率分别为73.91%和39.13%(P<0.05)。与对照组比较,治疗组1月后胃镜下胃黏膜充血、水肿减轻(P<0.05)。3月后治疗组再入院2例,对照组5例。结论联合治疗对PHG胃黏膜的改善有较好的治疗作用。

Objective To investigate the effect of proton pump inhibitor（PPI） plus H2 receptor antagonist（H2RA） in the treatment of portal hupertensive gastropathy （PHG）. Methods Forty - six patients of liver cirrhosis with PHG were equally randomized into test group and control group. 40 mg Omeprazole iv, qd and 10 mg propranolol orally tid were used to each group for 7 days. But in the test group, ranitidine （ 150 mg orally per night） was added. The rate of alleviatation of clinical symptom was compared after one week. The changes of gastric mucosa were observed under gastroscopy after a month. The re - admission rate was surveyed after three months. Results The rate of alleviatation was 39.13% in control group and 73.91% in test group （ P 〈 0.05 ）. Compared with control group, gastric mueosa＇s congestion and edema were significantly ameliorated （ P 〈 0.05 ） in test group one month later under the gastroscopy. Two patients were re - admission in test group and five patients in control group three months later. Conclusions The proton pump inhibitor combined H2 reeeptor antagonist has better therapeutic effect in PHG gastric mucosa.