埃索美拉唑联合马来酸曲美布汀治疗非糜烂性反流病的临床观察

Clinical observation of esomeprazole combined with trimebutine on treatment of non-erosive reflux disease

目的 探讨埃索美拉唑联合马来酸曲美布汀治疗非糜烂性反流病（NERD）的临床效果及复发情况.方法 将125例NERD患者应用计算机随机分为治疗组和对照组.治疗组62例,给予埃索美拉唑20 mg,每日2次口服;马来酸曲美布汀0.2g,每日3次口服.对照组63例,给予埃索美拉唑20mg,每日2次口服;枸橼酸莫沙必利5 mg,每日3次口服.疗程均为8周,并于停药后半年进行随访,比较两组临床疗效及复发情况.结果 治疗4周治疗组症状评价总有效率为75.8％ （47/62）,高于对照组的57.1％ （36/63）,差异有统计学意义（x2=4.879,P=0.027）;治疗8周治疗组症状评价总有效率为95.2％ （59/62）,高于对照组的84.1％ （53/63）,差异有统计学意义（x2=4.083,P=0.043）.治疗4周治疗组GERDQ评分有效率为72.6％ （45/62）,高于对照组的52.4％（33/63）,差异有统计学意义（x2=5.434,P=0.020）;治疗8周治疗组GERDQ评分有效为93.5％（58/62）,高于对照组的79.4％（50/63）,差异有统计学意义（x2=5.350,P=0.021）.停药半年后治疗组复发率为77.4％ （48/62）,对照组复发率为81.0％ （51/63）,差异无统计学意义（P =0.627）.结论 埃索美拉唑与马来酸曲美布汀联合治疗NERD安全有效.

Objective To investigate the effect and recurrence of the esomeprazole combined with trimebutine on treatment for non-erosive reflux disease（NERD）.Methods One hundred and twenty-five cases of patients with NERD were randomly divided into the treatment group （n =62） and the control group （n =63）.Patients in treatment group were received the esomeprazole 20 mg,twice a day and trimebutine 0.2 g,3 times a day,in control group were received the esomeprazole 20 mg,twice a day and mosapride 5 mg,3 times a day.After 8 weeks treatment,6 months follow-up was conducted and the effects and recurrence were evaluated.Results The clinical curative rates at 4th and 8th weeks treatment in treatment group were 75.8％ （47/62） and 95.2％ （59/62）,higher than that of control group （57.1％ （36/63）,x2 =4.879,P =0.027 ; 84.1％ （53/63）,x2 =4.083,P =0.043）.The GERDQ curative rates at 4th and 8th weeks treatment in treatment group were 72.6％ （45/62）,93.5％ （58/62） respectively,significantly higher than that of the control group （52.4％ （33/ 63）,x2 =5.434,P =0.020 ; 79.4％ （50/63）,x2 =5.350,P =0.021）.The recurrence rates of 6 months followup were 77.4％ （48/62） in the treatment group and 81.0％ （51/63） in the control group,there was no significant difference between the two groups （P =0.627）.Conclusion Esomeprazole combined with trimebutine is safe and effective treatment on non-erosive reflux disease,and the recurrence rates was lower than that in the control group.