不同方法治疗难治性胃食管反流病的疗效观察

Curative effect observation on different methods in the treatment of refractory gastroesophageal reflux disease

目的探讨不同方法治疗难治性胃食管反流病的临床疗效和安全性。方法 120例难治性胃食管反流病患者,随机分为A组和B组,每组60例。A组患者接受埃索美拉唑+莫沙必利治疗,B组患者接受埃索美拉唑+莫沙必利+铝碳酸镁治疗,均持续治疗8周。对比分析两组患者的临床症状改善情况、临床疗效及不良反应发生情况。结果治疗8周后,两组患者烧心、反酸、胸骨后疼痛、嗳气的临床症状评分均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05或<0.01)。B组患者显效26例,有效27例,无效7例,总有效率为88.33%,A组显效14例,有效28例,无效18例,总有效率为70.00%;两组总有效率比较差异有统计学意义(P<0.05)。A组嗜睡、口干、头晕和乏力的发生例数分别为2、3、4、2例,不良反应发生率为18.3%;B组嗜睡、口干、头晕和乏力的发生例数分别为2、1、3、2例,不良反应发生率为13.3%;两组不良反应发生率比较差异无统计学意义(χ~2=0.56,P>0.05)。结论埃索美拉唑联合莫沙必利和铝碳酸镁治疗难治性胃食管反流病的疗效显著,能够明显改善患者的临床症状,且安全性较高,在临床治疗难治性胃食管反流病时可考虑应用。

Objective To explore the clinical curative effect and safety of different methods in the treatment of refractory gastroesophageal reflux disease. Methods A total of refractory gastroesophageal reflux disease patients were randomly divided into group A and group B, with 60 cases in each group. Group A received esomeprazole ＋ mosapride for treatment, group B received esomeprazole ＋ mosapride ＋ hydrotalcite for treatment. Both groups all received continuous treatment for 8 weeks. Comparison and analysis on clinical symptom improvement, clinical curative effect and occurrence of adverse reactions in two groups. Results After 8 weeks of treatment, both groups had lower clinical symptom score of heartburn, sour regurgitation, retrosternal pain, belching than before treatment, and group B had lower points than group A, and the difference had statistical significance（P〈0.05 or〈 0.01）. Group B had 26 excellent cases, 27 effective cases and 7 ineffective cases, with total effective rate as 88.33%, while group A had 14 excellent cases, 28 effective cases and 18 ineffective cases, with total effective rate as 70.00%. Both groups had statistically significant difference in total effective rate（P〈0.05）. Group A had number of sleepiness, dry mouth, dizziness and fatigue cases respectively as 2, 3, 4 and 2 cases, with incidence of adverse reactions as 18.3%, while group B had number of sleepiness, dry mouth, dizziness and fatigue cases respectively as 2, 1, 3 and 2 cases, with incidence of adverse reactions as 13.3%. Both groups had no statistically significant difference in incidence of adverse reactions（χ2=0.56, P〉0.05）. Conclusion Combination of esomeprazole, mosapride and hydrotalcite shows significant curative effect in treating refractory gastroesophageal reflux disease, and it can obviously improve the clinical symptoms in patients with high safety. So it is recommended to be used in the treatment of refractory gastroesophageal reflux disease in clinic.