多潘立酮及铝碳酸镁治疗胆汁反流性胃炎多中心临床观察

Efficacy of domperidone and hydrotalcid on bile reflux gastritis: a multicenter clinical trail

目的 探讨多潘立酮对胆汁反流性胃炎的疗效及胃内 2 4h胆汁的影响。方法 5 5例经胃内 2 4h胆汁监测证实的胆汁反流性胃炎患者随机分为 3组。A组 2 0例 ,予以多潘立酮 10mg ,3次 /d治疗 4周 ;B组 15例 ,予以铝碳酸镁 1.0 g ,3次 /d治疗 4周 ;C组 2 0例 ,予以多潘立酮 10mg ,3次 /d及铝碳酸镁 1.0 g ,3次 /d治疗 4周。分别于治疗前及治疗 4周后观察 3组患者腹胀、上腹痛、恶心及呕吐症状变化 ,并于治疗后复查胃内 2 4h胆汁监测。结果 治疗后 3组患者症状均明显减轻 (P <0 .0 5 ) ,多潘立酮对患者腹胀、上腹痛、恶心及呕吐的总有效率分别为 85 .0 % ,6 6 .7% ,84 .6 %及 87.5 % ;铝碳酸镁组分别为 6 0 .0 % ,80 .0 % ,83.3%及 10 0 .0 % ;多潘立酮联合铝碳酸镁组分别为 88.9% ,82 .4 % ,83.3%及 10 0 .0 %。但各组间症状有效率的比较差异无显著性。 3组患者治疗后胃内 2 4h胆汁反流总时间百分比均显著下降 (P <0 .0 5 ) ,但下降幅度各组间比较差异无显著性 (P >0 .0 5 )。结论 多潘立酮可减少胃内胆汁反流 ,铝碳酸镁可结合胆酸 ,均为治疗胆汁反流性胃炎的有效药物。

Objective To investigate the effects of domperidone and hydrotalcid on bile reflux gastritis. Methods Fifty-five patients using 24 h gastric bilirubin monitoring proven bile reflux gastritis were randomly divided into three groups. Domperidone 10 mg three times daily for 4 weeks was given to 20 patients in group A; hydrotalcid 1.0 g three times daily for 4 weeks to 15 patients in group B; and domperidone 10 mg combined with hydrotalcid 1.0 g three times daily for 4 weeks to 20 patients in group C. Dyspepsia symptoms including abdominal fullness, abdominal pain, nausea and vomiting were evaluated during visits before or 4 weeks after treatment. Four weeks after treatment, the 24 h gastric bilirubin monitoring was reexamined in all patients. Results After 4 weeks treatment all symptoms had been improved, and symptom scores were significantly decreased ( P <0.05). The total symptom improvement rate of domperidone to abdominal fullness, abdominal pain, nausea and vomiting were 85.0%, 66.7%, 84.6% and 87.5%, while that of hydrotalcid were 60.0%,80.0%,83.3% and 100.0%, and that of domperidone combined with hydrotalcid were 88.9%,82.4,83.3% and 100.0% respectively. However, there were no significant differences in the total symptom improvement rates among three groups ( P >0.05). After the medication, the total time percentage of 24 h bile reflux was remarkably decreased in each group ( P <0.05), however, there were no significant differences in the reduction rates among three groups ( P >0.05). Conclusions Domperidone can decrease the gastric bile reflux and hydrotalcid can combine bile acid, both are effective in the treatment of bile reflux gastritis.