铝碳酸镁治疗胆汁反流性胃炎的实验与临床研究

Effect of hydrotalcite on bile-reflux gastritis in rats and humanness

目的 :观察铝碳酸镁对实验性大鼠胆汁反流性胃炎的治疗效果和对胆汁反流性胃炎患者的临床治疗效果。方法 :实验研究采用纵形切开大鼠胃幽门括约肌 ,制造胆汁反流性胃炎的实验模型并分组喂饲铝碳酸镁或硫糖铝 0 5g·d-1。 2wk或 4wk后取鼠全胃分送病理光镜与电镜检查。临床研究以胃镜下诊断为胆汁反流性胃炎的患者 ,随机接受铝碳酸镁或硫糖铝治疗 ,并逐日记录临床症状 ,其中治疗组有 30例于治疗 2wk后作胃镜复查。结果 :临床观察见铝碳酸镁治疗胆汁反流性胃炎的1wk显效率达 42 36 % ,总有效率为 89 6 5 % ;2wk的治疗显效率达 70 5 7% ,总有效率为 10 0 % ;铝碳酸镁的 1wk疗效与硫糖铝2wk疗效相似 ,明显优于硫糖铝对照组 (P <0 0 1) ;胃镜复查见胆汁反流和胃黏膜糜烂均有明显的好转。实验大鼠的病理光镜与电镜检查结果也见铝碳酸镁的疗效优于硫糖铝对照组。结论

AIM: To study the curative effect of hydrotalcite on bile reflux gastritis. METHODS: ① Bile reflux gastritis was produced in 30 rats with pyloric sphincter incision and the gastric mucosa of rats were examined with microscopy and electron microscopy after 2 and 4 wk of treatment with 0.5 g·d -1 hydrotalcite or sucrafate. ② Two hundred and fifty patients with bile reflux gastritis between November 1998 and October 2000 were prospectively and randomly divided into 2 groups. The control groups ( n =47) treated with 1.0 g,tid sucrafate and the rest patients ( n=203 ) treated with 1.0 tid hydrotalcite. The effect of treatments was evaluated by symptoms score and gastoendoscopy. RESULTS: ① The healing rate of gastric mucosa of rate with hydrotalcite (0.5 g·d -1 ) was obviously more than with sucralate (0.5g·d -1 ). ② The ramarkable healing rate of symptoms were 42.36%, 70.57% and the total effective rate were 89.65%, 100% respectively after 1 and 2 wk of treatment with hydrotalcite, that also obviously excelled sucralfate ( P <0 01). CONCLUSION: Hydrotalcite is an effective drug on bile reflux gastritis.