兰索拉唑联合莫沙必利治疗老年反流性食管炎的临床研究

Combined lansoprazole with mospride in treatment of aged reflux esophagitis

目的观察兰索拉唑联合莫沙必利治疗老年人反流性食管炎的临床疗效。方法80例内镜检查阳性的反流性食管炎患者给予兰索拉唑30mg，1次／d，莫沙必利5mg，3；L／d治疗，疗程8周，记录治疗1、2、4、8周时反酸、烧心等症状变化，疗程结束后复查胃镜了解食管炎愈合情况，并在疗程结束后1、3、6、12个月进行随访。结果兰索拉唑治疗1周，症状记分即较治疗前明显下降（P〈0．01）；治疗2、4、8周后，症状显效率分别为62．50％、86．25％及92．50％。8周后I级食管炎治愈率为92．86％，高于Ⅱ级75．76％和Ⅲ级54．54％（P〈0．05）；疗程结束后1、3、6、12个月随访时临床症状复发率分别为5．12％、17．33％、45．83％和76．81％。疗程结束12个月后，食管炎复发率为79．17％，内镜下表现为I级食管炎44．72％，Ⅱ级34．21％，Ⅲ级21．05％。无明显药物不良反应。结论兰索拉唑联合莫沙必利治疗老年人反流性食管炎是较安全有效的短期治疗方案。

Objective To observe the effect of lansoprazole with mospride on reflux esophagitis. Methods Eighty patients with endoscopically proven reflux esophagitis were assessed in our hospital with lansoprazole 30 mg once daily and mospride 5 mg three times a day. Reflux symptoms including regurgitation, heartburn and food reflux were evaluated during visits after 1, and 4 and 8 weeks. At the eighth week, endoscopy was performed to study the healing rate, and a follow-up was taken at 1, 3, 6 and 1 months after the treatment. Results After one-week treatment with lansoprazole with mospride, all symptoms had been improved, and symptom scores were greatly decreased （P 〈 0.01 ）. Symptom relief was achieved by 6.5% , 86.5% and 9.5% after, 4 and 8 weeks respectively. At the end of the treatment, the endoscopic healing rate was 9.86% in esophagitis type ] , which was much higher than type Ⅱ of 75.76% and type m of 54.54% （P 〈 0. 05）. The symptoms relapse rate in the 1 st,3rd,6th and lth month after the treatment was 5. 1%, 17. 33%, 45. 83% and 76. 81% （53/69）. Twelve months after the treatment, the esophagitis proved by endoscopy was 79.17%, in which, 44.7% for type I , 34.1% for type Ⅱ and 1.05% for type ⅢThere were no obvious side effects. Conclusion Lansoprazole with mospride is effective in the treatment of aged reflux esophagitis.