Impact of preoperative therapy on surgical outcomes of laparoscopic total gastrectomy for gastric/gastroesophageal junction cancer

Objective: As laparoscopic surgery is widely applied for primarily treated gastric cancer(GC)/gastroesophageal junction cancer(GEJC) and gains many advantages, the feasibility of laparoscopic total gastrectomy(LTG) for GC/GEJC patients who have received preoperative therapy(PT) has come to the fore. This study aims to analyze the safety and feasibility of LTG after PT for GC/GEJC patients.Methods: We retrospectively analyzed the data of 511 patients with GC/GEJC undergoing LTG, of which 405received LTG(LTG group) and 106 received PT+LTG(PT-LTG group) at Nanfang Hospital between June 2018and September 2022. The surgical outcomes were compared between the two groups.Results: The surgical duration was significantly longer in the PT-LTG group(P<0.001), while the incidence of intraoperative complications(P=1.000), postoperative complications(LTG group vs. PT-LTG group: 26.2% vs.23.6%, P=0.587), the classification of complication severity(P=0.271), and postoperative recovery was similar between two groups. Notably, the incidence of anastomotic complications of esophagojejunostomy was also comparable between the two groups(LTG group vs. PT-LTG group: 5.9% vs. 5.7%, P=0.918). The univariate and multivariate analysis confirmed that positive proximal margin [positive vs. negative: odds ratio(OR)=14.094, 95%confidence interval(95% CI): 2.639-75.260, P=0.002], rather than PT, has an impact on anastomotic complications after LTG(OR=0.945, 95% CI: 0.371-2.408, P=0.905).Conclusions: PT did not increase the surgical risk of LTG for GC/GEJC. Therefore, considering the positive effect of PT on long-term survival, the broader application of PT and LTG for GC/GEJC is supported by our findings.

Efficacy and safety of anti-PD-1/anti-PD-L1 antibody therapy in treatment of advanced gastric cancer or gastroesophageal junction cancer: A meta-analysis

BACKGROUND Faced with limited and inadequate treatment options for patients with advanced gastric cancer or gastroesophageal junction cancer(GC/GEJC), researchers have turned toward, with the support of promising clinical trials, anti-PD-1/anti-PD-L1 antibody therapy. But there are also different clinical trial results. To better assess its efficacy and safety, we integrated data from 13 eligible studies for a systematic review and meta-analysis.AIM To comprehensively evaluate the efficacy and safety of anti-PD-1/anti-PD-L1 antibody therapy in the treatment of advanced GC/GEJC patients.METHODS PubMed, Web of Science, Cochrane Library,and EMBASE databases were searched to identify eligible articles with outcomes including objective response rate(ORR), disease control rate(DCR), overall survival(OS), progression-free survival(PFS), and adverse events(AEs) of anti-PD-1/anti-PD-L1 antibody therapy.RESULTS Our study encompassed a total of 13 trials totaling 1618 patients. The outcomes showed a pooled ORR and DCR of 15%(95% confidence interval [CI]: 14%-18%) and 40%(95%CI: 33%-46%), respectively. The pooled 6-mo OS and PFS were 54%(95%CI: 45%-64%) and 26%(95%CI: 20%-32%), respectively, and the 12-mo OS and PFS were 42%(95%CI: 21%-62%) and 11%(95%CI: 8%-13%), respectively. In addition, the incidence of any-grade AEs and grade ≥ 3 AEs was 64%(95%CI: 54%-73%) and 18%(95%CI: 16%-20%), respectively. Most importantly, PD-L1 positive patients exhibited a higher ORR rate than PD-L1 negative patients(odds ratio = 2.54, 95%CI: 1.56-4.15).CONCLUSION Anti-PD-1/anti-PD-L1 antibody therapy has shown promising anti-tumor efficacy with manageable AEs in advanced GC/GEJC patients, with PD-L1 overexpressing patients exhibiting a higher ORR. What is more, the clinical efficacy of anti-PD-1/PD-L1 combined with traditional chemotherapy drugs is even better, although the occurrence of AEs still causes considerate concerns.

Analysis of feasibility of application of Beishu point acupressure therapy in treating gastroesophageal reflux disease via AMPK / ULK1 mediated autophagy pathway based on "adjusting central axis via pivot" theory

Gastroesophageal reflux disease(GERD)is a digestive system disease characterized by uncomfortable symptoms caused by reflux of gastric contents.It has increased sharply with the development of my country’s society and economy.If there is no reasonable and effective Prevention and treatment measures will inevitably increase the financial burden of patients,and also pose a major threat to the quality of life and health of patients.Cell signal transduction mediated by various receptors participates in the regulation mechanism of the body's various levels of biological functions.By inhibiting or activating its functions,the purpose of curing diseases can be achieved,and cell signal transduction has been used in traditional Chinese medicine.Studying.The theory of"adjusting the central axis"was explored by Professor Xie Sheng through decades of clinical experience.It has been proven in practice to treat GERD.It starts from the model of TCM viscera and expounds that the pathogenesis of GERD involves multiple viscera.Multi-system and multi-factor,explain the correlation of the disease with a variety of zang-fu syndromes,and use this as a basis to guide the clinical use of hidden prescriptions.The back-shu pointer therapy can prevent GERD by correcting the unbalanced state of the viscera and qi machine,and promoting the junction of the two channels of Ren and Du.Based on the theory of"adjusting the hub by the pivot",this article expounds the pathogenesis of GERD from the perspective of traditional Chinese medicine.By consulting the literature and combining with the previous research,it proposes to analyze the methods and methods of Backshu pointer therapy to prevent and treat GERD from the AMPK/ULK1 mediated autophagy pathway.

Efficacy of mosapride plus proton pump inhibitors for treatment of gastroesophageal reflux disease: A systematic review

AIM:To assess the potential benefits of mosapride plus proton pump inhibitors(PPIs)in the treatment of gastroesophageal reflux disease.METHODS:A literature search was performed through MEDLINE,EMBASE,and the ISI Web of Knowledge.The clinical trials that compared the benefit of mosapride plus PPI treatment with that of PPI monotherapy were analyzed.The rate of responders was evaluated by the pooled relative risk(PRR)and improvement in symptom scores was assessed by single effect size of a standardized mean,while Hedges’g was used as the effect size.Pooled effect sizes with 95%CIs were calculated using a fixed-effects model.Between-study heterogeneity was assessed using Q test and I2analyses.In addition,studies that assessed the additional efficacy of mosapride in PPI-resistant patients were also reviewed.RESULTS:This systematic review included information on a total of 587 patients based on 7 trials.Four trials compared the efficacy of combination therapy of mosapride plus a PPI with that of PPI monotherapy.The statistical analysis for the effect of additional mosapride showed equivocal results(PRR=1.132;95%CI:0.934-1.372;P=0.205;Hedges’g=0.24;95%CI:0.03-0.46;P=0.023).No heterogeneity and publication bias were found among the studies.Three openlabeled trials assessed the additional efficacy of mosapride in PPI-resistant patients.However,since these trials did not set the control group,the results may be considerably biased.CONCLUSION:Mosapride combined therapy is not more effective than PPI alone as first-line therapy.Whether it is effective in PPI-resistant patients needs to be determined.

Gastroesophageal reflux and Helicobacter pylori:a review

INTRODUCTION Since the observation by Labenz et al thateradication of Helicobacter pylori(Hp)infectionmay be followed by development of refluxesophagitis in a relevant proportion of duodenalulcer patients previously not affected bygastroesophageal reflux disease(GERD),agrowing attention has been given to the

Role of stenting in the palliation of gastroesophageal junction cancer: A brief review

Gastroesophageal junction cancer has an increasing in-cidence in western countries. It is inoperable when firstmanifested in more than 50% of cases. So, palliationis the only therapeutic option for the advanced diseaseto relieve dysphagia and its consequences in weakenedpatients with an estimated mean survival under 6 mo.This article has tried to identify trends focusing on cur-rent information about the best palliative treatment,with an emphasis on the role of stenting. Self-expand-ing stent placement, either metal or plastic, is the mainmanagement option. However, this anatomical loca-tion creates some particular problems for stent safetyand effectiveness which may be overcome by properlydesigned novel stents. The stents ensure a good qual-ity of life and must be preferred over other alterna-tive methods of loco-regional modalities, i.e., externalradiation, laser thermal or photodynamic therapy. Al-though stent placement is generally a simple, safe andeffective method, there are sometimes complications,increasing the morbidity and mortality rate. Bypassoperative procedures have now been abandoned as afirst choice. The stomach instead of the colon must beused for a bypass operation when it is needed. Chemo-therapy, despite the toxicity, and intraluminal radiation(brachytherapy) have a well-defined role.

Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

AIM:To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease(GERD).METHODS:After unblinding and crossover,50 patients(32 males,18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized,placebo-controlled,single-center study,and included in the present prospective open-label follow-up study.Initially,three gastroplications using the Endocinch device were placed under deep sedation in a standardized manner.Optional retreatment was offered in the first year with 1 or 2 extra gastroplications.At baseline,3 mo after(re) treatment and yearly proton pump inhibitor(PPI) use,GERD symptoms,quality of life(QoL) scores,adverse events and treatment failures(defined as:patients using > 50% of their baseline PPI dose or receiving alternative antireflux therapy) were assessed.Intention-to-treat analysis was performed.RESULTS:Median follow-up was 48 mo [interquartile range(IQR):38-52].Three patients were lost to follow-up.In 44% of patients retreatment was done after a median of 4 mo(IQR:3-8).No serious adverse events occurred.At the end of follow-up,symptom scores and4 out of 6 QoL subscales were improved(all P < 0.01compared to baseline).However,80% of patients required PPIs for their GERD symptoms.Ultimately,64% of patients were classified as treatment failures.In 60% a post-procedural endoscopy was carried out,of which in 16% reflux esophagitis was diagnosed.CONCLUSION:In the 4-year follow-up period,the subset of GERD patients that benefit from endoscopic gastroplication kept declining gradually,nearly half opted for retreatment and 80% required PPIs eventually.

Refractory chronic cough due to gastroesophageal reflux: Definition, mechanism and management

Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.

Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux

AIM： To study the effect of combined omeprazole（Ome） and domperidone（Dom） therapy on asthma symptoms and pulmonary function in asthmatics with gastroesoph- ageal reflux. METHODS： We selected 198 asthmatics with gastro- esophageal reflux diagnosed by 24-h esophageal pH moni- toring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk （1：1 double-blind randomization）. Spirometry was done at baseline and after 16 wk of treatment. The primary outcome measures were： mean daily daytime and nighttime asthma symptom scores. Mean daily reflux symptom scores, albuterol use as rescue medication （number of puffs）, daytime and nighttime peak expiratory flow rate （PEFR）, postbronchodilator forced expiratory volume in 1 second （FEVl） and postbronchodilator forced vital capacity （FVC） were secondary outcome measures. RESULTS： Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score （17.4% vs 8.9 %）, nighttime asthma symptom score （19.6% vs 5.4%）, reflux symptom score （8.7% vs 1.6%） and rescue medication use （23.2% vs 3.1%） after antireflux therapy compared to mean change in placebo group （P 〈 0.001）. There was significant improvement in morning PEFR （7.9% vs 0.2%）, evening PEFR （9.8% vs 0.5%）, FEW （11.1% vs 3.78%） and FVC （9.3%vs 1.52%） in the antireflux therapy group compared to placebo on comparng the mean change from baseline after 16 wk （P 〈 0.01） CONCLUSION： Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medi- cation use, and improving pulmonary function.

Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting

AIM: To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy. METHODS: Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) study.The two institutions are situated in geographically and socially disparate areas. Data collection was by selfcompletion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it's clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed. RESULTS: Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e. , after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement. CONCLUSION: The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy.

Positive predictors for gastroesophageal reflux disease and the therapeutic response to proton-pump inhibitors

AIM: To identify objective and subjective predictors for the reliable diagnosis of gastroesophageal reflux disease (GERD) and the response to proton pump inhibitor (PPI) therapy.

半夏泻心汤加减联合艾司奥美拉唑镁肠溶片治疗非糜烂性胃食管反流病肝胃郁热证疗效及安全性

目的观察半夏泻心汤加减联合艾司奥美拉唑镁肠溶片治疗非糜烂性胃食管反流病(NERD)肝胃郁热证的疗效及安全性。方法选择NERD肝胃郁热证患者98例,按随机数字表法分为2组,对照组(n=49)予艾司奥美拉唑镁肠溶片,治疗组(n=49)在对照组基础上辅以半夏泻心汤加减,连续治疗8周。比较2组疗效及治疗前后中医证候总积分、食管动力[下食管括约肌静息压(LESP)、上食管括约肌静息压(UESP)]、胃肠激素[胃动素、胃泌素、胃促生长素(Ghrelin)、血管活性肠肽(VIP)]、汉密尔顿抑郁量表-17(HAMD-17)评分变化,并观察2组治疗期间不良反应发生情况。结果治疗组总有效率为95.92%(47/49),对照组为73.47%(36/49),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候总积分、HAMD-17评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。2组治疗后LESP均较本组治疗前升高(P<0.05),UESP均较本组治疗前降低(P<0.05);治疗后治疗组LESP高于对照组(P<0.05),UESP低于对照组(P<0.05)。2组治疗后胃动素、胃泌素、Ghrelin均较本组治疗前升高(P<0.05),VIP均较本组治疗前降低(P<0.05);治疗后治疗组胃动素、胃泌素、Ghrelin高于对照组(P<0.05),VIP低于对照组(P<0.05)。2组治疗期间均未发生不良反应。结论半夏泻心汤加减联合艾司奥美拉唑镁肠溶片治疗NERD肝胃郁热证疗效肯定,能改善食管动力及抑郁状态,调节胃肠激素,且安全性高。

半夏泻心汤联合氟哌噻吨美利曲辛片治疗非糜烂性胃食管反流病临床观察

目的分析半夏泻心汤加减联合氟哌噻吨美利曲辛片治疗非糜烂性胃食管反流病(NERD)的临床效果。方法共选取了68例来源于枣庄市薛城区人民医院的NERD患者,时间段为2020年1月—2022年7月,以随机数字表法分为对照组和观察组,各34例。对照组以氟哌噻吨美利曲辛片治疗,观察组以氟哌噻吨美利曲辛片联合半夏泻心汤加减治疗,比较两组疗效、胃内分泌指标,分析食管动力指标,观察病症指标,统计不良反应发生情况。结果观察组治疗总有效率97.06%(33/34)高于对照组的76.47%(26/34)(P<0.05)。治疗后,观察组食管收缩波幅(CA)、食管下括约肌压力(UESP)及食管下括约肌静息压(LESP)数值均高于对照组(P<0.05);症状评分、发作次数、发作时间均低于对照组(P<0.05);胃泌素及血管活性肠肽水平低于对照组,胃动素水平高于对照组(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论半夏泻心汤加减联合氟哌噻吨美利曲辛片治疗NERD具有确切效果,可以改善食管动力和胃内分泌指标水平,减轻病情,促进机体康复,且具有安全性,值得使用。

从虚、郁、瘀论治胃食管反流病

胃食管反流病是消化科常见的疾病之一,中医在治疗胃食管反流病方面具有一定的优势。此文从“虚、郁、瘀”理论出发,认为脾虚为发病之本,肝郁推动疾病发展,血瘀使疾病难愈;临床应以健运脾胃、条达肝气、活血祛瘀为治疗原则,使正气得复、邪气得除,以提高临床治疗胃食管反流病的效果,为中医治疗胃食管反流病提供新的角度。

近端胃切除术后胃食管反流病的研究进展

胃食管反流病(GERD)是一种常见的消化系统疾病,其病因复杂且反复发作,给临床医师带来了很大的困扰。近端胃切除术作为一种治疗胃癌等疾病的手术方法,破坏了贲门及周边的生理结构,可能导致术后残胃反酸、反流现象的发生,从而引发GERD。这种情况严重影响了患者的生活质量。本文主要对近端胃切除术后GERD的发病机制、治疗方法以及抗反流术式的进展进行了总结,旨在为近端胃切除术后GERD治疗方案的选择提供参考依据。

基于“通化宣平”理论运用经典名方辨治胃食管反流病

胃食管反流病(GERD)是临床常见的消化系统疾病,缠绵难愈,病因病机繁杂。基于“通化宣平”理论,运用经典名方燮理阴阳、平调寒热、通畅气机、补虚泻实,切中GERD治疗要旨,疗效显著。

清热降逆法治疗胃食管反流病疗效的Meta分析

目的:评价清热降逆法治疗胃食管反流病的临床疗效。方法:通过检索中国知网(CNKI)、万方数据库(WANFANG)、维普数据库(VIP)、中国生物医学数据库(SinoMed)及PubMed、Cochrane Library等数据库,收集建库至2023年10月发表的清热降逆法治疗胃食管反流病的临床随机对照试验(RCT)文献,使用RevMen 5.3软件进行Meta分析。结果:共纳入15篇文献,包含1199例患者。Meta分析结果表明清热降逆法试验组的临床总有效率[RR=1.20,95%CI(1.15,1.27),Z=7.34,P<0.00001]和内镜有效率[RR=1.14,95%CI(1.04,1.26),Z=2.76,P=0.006]均优于常规西药对照组,复发率[RR=0.30,95%CI(0.14,0.65),Z=3.06,P=0.002]低于常规西药对照组,差异有统计学意义(P<0.05)。结论:清热降逆法治疗胃食管反流病有较好的临床疗效,但纳入文献质量较低,仍需依靠高质量、大样本、多中心的研究进行进一步验证。

1例天使综合征合并重症肺炎患儿的护理

目的:总结1例天使综合征合并重症肺炎患儿的护理经验。方法:给予经鼻高流量氧疗(HFNC)联合俯卧位通气及机械振动排痰、雾化、吸痰等措施改善患儿呼吸功能,同时加强患儿胃食管反流伴吞咽障碍的护理,锻炼患儿经口进食的能力,注重舒适护理,同时为患儿家属做好健康宣教。结果:患儿在医院儿童重症医学科(PICU)治疗15 d后,胸片显示患儿肺部感染情况有所好转,鼻导管给氧下可维持血氧饱和度在正常范围,吞咽功能恢复可经口进食,病情稳定转至普通病房继续治疗。结论:对于天使综合征合并肺炎患儿的治疗,在控制肺部炎症的同时做好胃食管反流的护理并加强吞咽功能的锻炼,对家属做好健康宣教,不仅可提高救治效果、促进病情稳定,还可以降低患儿肺炎复发率,提高其日后的生存质量。

活血化瘀生肌方对瘀血阻络型胃食管反流病肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响

目的观察活血化瘀生肌方对瘀血阻络型胃食管反流病患者肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响。方法将115例胃食管反流病患者按照随机数字表法分为2组,对照组57例予常规西医治疗,治疗组58例在对照组治疗基础上予活血化瘀生肌方治疗。连续治疗1个月。比较2组治疗前后血清胃蛋白酶原Ⅰ(PGⅠ)、转化生长因子α(TGF-α)、胃蛋白酶原Ⅱ(PGⅡ)、胆囊收缩素(CCK)水平,肠道葡萄球菌、乳酸菌、双歧杆菌数量,食管动力指标(食管括约肌压力、食管远端收缩积分平均值、总反流时间百分比),中医证候评分,胃酸分泌量,胃液胆酸量,以及反流性疾病问卷(RDQ)评分,统计2组临床疗效。结果治疗组总有效率96.55%(56/58),对照组总有效率82.46%(47/57),治疗组临床疗效优于对照组(P<0.05)。2组治疗后PGⅠ、TGF-α水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后PGⅡ、CCK水平均降低(P<0.05),治疗组治疗后均低于对照组(P<0.05)。2组治疗后肠道乳酸菌、双歧杆菌数量均较本组治疗前升高(P<0.05),治疗组治疗后均高于对照组(P<0.05);2组治疗后葡萄球菌数量均降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后食管括约肌压力、食管远端收缩积分平均值均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后总反流时间百分比均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后胃酸分泌量、胃液胆酸量及RDQ评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。结论活血化瘀生肌方治疗瘀血阻络型胃食管反流病患者,可改善胃蛋白酶原指标,促进胃黏膜损伤修复,平衡肠道菌群,提高食管动力,缓解患者中医证候及临床症状,提升临床疗效。

解郁和胃汤联合三联疗法对胃食管反流病患者神经肽类物质、胃动力调节激素的影响

目的:观察解郁和胃汤联合三联疗法对胃食管反流病患者神经肽类物质、胃动力调节激素的影响。方法:选取我院于2018年5月~2020年6月收治的胃食管反流病患者134例,根据治疗方案分为两组。对照组采用三联疗法治疗,观察组采用解郁和胃汤联合三联疗法治疗。统计两组总有效率,记录两组中医症候积分、神经肽类物质、胃动力调节激素及食管下括约肌压力(LESP)及其长度(LESL)变化。结果:与治疗前比较,两组的酸反流、胃灼热等主症和胸骨后痛、胀腹感、胃脘痛、嗳气、多怒、善饥等次症下降,且观察组治疗后中医症候积分较对照组低(P<0.05)。与治疗前比较,两组的胃泌素(GAS)、胃动素(MTL)、生长激素释放肽(Ghrelin)上升,P物质(SP)、降钙素基因相关肽(CGRP)、血管活性肠肽(VIP)下降,且观察组治疗后GAS、MTL、Ghrelin较对照组高,神经肽类物质指标、VIP较对照组低(P<0.05)。与治疗前比较,两组的LESP及LESL上升,且观察组治疗后LESP及LESL较对照组高(P<0.05)。观察组胃镜检查有效率高于对照组,有统计学意义(P<0.05)。结论:解郁和胃汤联合三联疗法治疗胃食管反流病可调节患者神经肽类物质、胃动力调节激素的表达,减轻症状,改善食管压力,提高疗效。