雷贝拉唑与马来酸曲美布汀对胃食管反流患者胃食管动力学的影响

Effect of rabeprazole and trimebutine maleate on gastroesophageal dynamics in patients with gastroesophageal reflux disease

目的探讨雷贝拉唑与马来酸曲美布汀对胃食管反流患者胃食管动力学的影响。方法选取我院消化内科收治的胃食管反流病患者200例作为研究对象，随机分为对照组和观察组各100例，对照组口服质子泵抑制剂雷贝拉唑片治疗，观察组采用雷贝拉唑联合马来酸曲美布汀胶囊治疗。检测两组患者治疗前后胃食管动力学和胃电活动指标，并对临床疗效进行统计学分析。结果观察组总有效率（96％）明显高于对照组（79％），差异有统计学意义（Х^2=11．703，P〈0．05）。观察组患者治疗后胃窦收缩幅度、胃窦运动指数及胃窦收缩频率分别为（1．91±0．44）、（2．03±0．81）、（2．47±0．95），对照组分别为（1．22±0．35）、（1．12±0．47）、（2．05±0．59），观察组均显著高于对照组（P〈0．05）。观察组治疗后食管蠕动性收缩比、括约肌压力及食管括约肌松弛率分别为（94．2±16．0）％、（19．32±1．45）mmHg、（75．8±6．6）％，对照组分别为（86．1±13．8）％、（13．42±1．38）mmHg、（58．8±6．0）％，观察组均显著高于对照组（P〈0．05）。观察组患者治疗后餐前及餐后的主频、主功率分别为（4．1±0．8）、（4．4±0．6）、（100．4±26．9）、（165．6±36．6），对照组分别为（3.3±0．9）、（3．3±0．5）、（91．1±28．5）、（155．1±35．0），观察组均显著高于对照组（P〈0．05）。治疗8周后观察组空腹、餐后的正常慢波节律为（42．8±22．6）、（66．1±21．7），显著高于对照组的（41．5±20．0）、（50．4±21．6），而餐后胃动过缓（29，4±19．3）明显低于对照组（41．8±23．1）（P〈0．05）。结论雷贝拉唑与马来酸曲美布汀能够提高胃食管动力，增加收缩力，使患者正常慢波节律减少，增加餐后胃电正常慢波百分比，改善胃排空，是一种安全、高效的治疗CERD的方法。

Objective To investigate the effect of rabeprazole and trimebutine maleate on gastroesophageal dynamics in patients with gastroesophageal reflux disease （GERD）. Methods 200 cases of GERD admitted in our hospital were selected as research object, and randomly divided into control group and observation group with 100 cases in each group. Control group was treated with proton pump inhibitor （rabeprazole tablets）, observation group was treated with rabeprazole tablets and trimebutine maleate capsules. Detected gastroesophageal dynamics and gastric electrical activity indicators before and after treatment of two groups, analyzed clinical efficacy of two groups. Results The total effective rate of observation group was obviously higher than that of control group （96.0% vs.79.0%）, with statistically significant difference （Х^2=11.703, P〈0.05）. After treatment, gastric antrum contraction amplitude, gastric antrum movement index and gastric antrum contraction frequency in observation group were （1.91±0.44）, （2.03±0.81）, （2.47±0.95） respectively, and those in control group were （1.22±0.35）, （1.12±0.47）, （2.05±0.59） respectively, those in observation group were significantly higher than those in control group （P〈0.05）. After treatment, esophageal peristalsis contraction ratio, sphincter pressure and esophageal sphincter relaxation ratio in observation group were （94.2±16.0）%, （19.32±1.45） mmHg, （75.8±6.6）% respectively, those in control group were （86.1±13.8）%, （13.42±1.38） mmHg, （58.8±6.0）% respectively, those in observation group were significantly higher than those in control group （P〈0.05）. After treatment, preprandial and postprandial dominant frequency, dominant power in observation group were （4.1±0.8）, （4.4±0.6）, （100.4±26.9）, 065.6±36.6） respectively, and those in control group were （3.3±0.9）, （3.3±0.5）, （91.1±28.5）, （155.1±35.0） respectively, those in observation group were significantly higher than those in control group （P〈0.05）. After 8 weeks＇ treatment, fasting and postprandial normal rhythm of slow wave in observation group were （42.8±22.6）, （66.1±21.7）, significantly higher than （41.5±20.0）, （50.4±21.6） in control group, and postprandial bradygastria in observation group was significantly lower than that in control group [（29.4±19.3） vs.（41.8±23.1）] （P〈0.05）. Conclusion Rabeprazole and trimebutine maleate can increase gastroesophageal motility, contractility, so that reduce normal rhythm of slow wave of patients, increase postprandial the percentage of normal slow waves of gastric electricity, and improve gastric emptying, which is a safe and efficient method for the treatment of GERD.