目的探究复发性反流性食管炎采用富马酸伏诺拉生片治疗的临床疗效。方法拟将2020年11月—2022年4月收治的80例复发性反流性食管炎患者为研究对象,以随机数字表法为依据,分为两组,对照组患者采用奥美拉唑肠溶胶囊治疗,观察组采用富马酸...目的探究复发性反流性食管炎采用富马酸伏诺拉生片治疗的临床疗效。方法拟将2020年11月—2022年4月收治的80例复发性反流性食管炎患者为研究对象,以随机数字表法为依据,分为两组,对照组患者采用奥美拉唑肠溶胶囊治疗,观察组采用富马酸伏诺拉生片治疗,两组患者均治疗8周,对比两组临床疗效、治疗前后胃肠激素指标[胃泌素(GAS)、血浆胃动素(MTL)]变化情况、症状改善情况、食管24 h pH监测结果、疾病复发情况。结果相较于对照组(67.50%),观察组(87.50%)治疗总有效率更高(P<0.05);相较于治疗前,两组治疗后各项症状评分均有所降低,且观察组低于对照组(P<0.05);相较于治疗前,两组治疗后GAS、MTL水平均有所提高,且观察组高于对照组(P<0.05);相较于治疗前,两组治疗后各项反流次数均有所减少,且观察组少于对照组(P<0.05);相较于对照组(17.50%),观察组(2.50%)的疾病复发率更低(P<0.05)。结论复发性反流性食管炎采用富马酸伏诺拉生片治疗的临床疗效显著,可改善临床症状与胃肠激素水平,减少反流次数,且疾病复发率低,具有良好的临床推广价值。展开更多
AIM:To investigate the prevalence of gastroesophageal reflux disease(GERD) in patients with a laryngoscopic diagnosis of laryngopharyngeal reflux(LPR).METHODS:Between May 2011 and October 2011,41 consecutive patients ...AIM:To investigate the prevalence of gastroesophageal reflux disease(GERD) in patients with a laryngoscopic diagnosis of laryngopharyngeal reflux(LPR).METHODS:Between May 2011 and October 2011,41 consecutive patients with laryngopharyngeal symptoms(LPS) and laryngoscopic diagnosis of LPR were empirically treated with proton pump inhibitors(PPIs) for at least 8 wk,and the therapeutic outcome was assessed through validated questionnaires(GERD impact scale,GIS;visual analogue scale,VAS).LPR diagnosis was performed by ear,nose and throat specialists using the reflux finding score(RFS) and reflux symptom index(RSI).After a 16-d wash-out from PPIs,all patients underwent an upper endoscopy,stationary esophageal manometry,24-h multichannel intraluminal impedance and pH(MII-pH) esophageal monitoring.A positive correlation between LPR diagnosis and GERD was supposed based on the presence of esophagitis(ERD),pathological acid exposure time(AET) in the absence of esophageal erosions(NERD),and a positive correlation between symptoms and refluxes(hypersensitive esophagus,HE).RESULTS:The male/female ratio was 0.52(14/27),the mean age ± SD was 51.5 ± 12.7 years,and the mean body mass index was 25.7 ± 3.4 kg/m 2.All subjects reported one or more LPS.Twenty-five out of 41 patients also had typical GERD symptoms(heartburn and/or regurgitation).The most frequent laryngoscopic findings were posterior laryngeal hyperemia(38/41),linear indentation in the medial edge of the vocal fold(31/41),vocal fold nodules(6/41) and diffuse infraglottic oedema(25/41).The GIS analysis showed that 10/41 patients reported symptom relief with PPI therapy(P < 0.05);conversely,23/41 did not report any clinical improvement.At the same time,the VAS analysis showed a significant reduction in typical GERD symptoms after PPI therapy(P < 0.001).A significant reduction in LPS symptoms.On the other hand,such result was not recorded for LPS.Esophagitis was detected in 2/41 patients,and ineffective esophageal motility was found in 3/41 patients.The MII-pH analysis showed an abnormal AET in 5/41 patients(2 ERD and 3 NERD);11/41 patients had a normal AET and a positive association between symptoms and refluxes(HE),and 25/41 patients had a normal AET and a negative association between symptoms and refluxes(no GERD patients).It is noteworthy that HE patients had a positive association with typical GERD-related symptoms.Gas refluxes were found more frequently in patients with globus(29.7 ± 3.6) and hoarseness(21.5 ± 7.4) than in patients with heartburn or regurgitation(7.8 ± 6.2).Gas refluxes were positively associated with extraesophageal symptoms(P < 0.05).Overall,no differences were found among the three groups of patients in terms of the frequency of laryngeal signs.The proximal reflux was abnormal in patients with ERD/NERD only.The differences observed by means of MII-pH analysis among the three subgroups of patients(ERD/NERD,HE,no GERD) were not demonstrated with the RSI and RFS.Moreover,only the number of gas refluxes was found to have a significant association with the RFS(P = 0.028 andP = 0.026,nominal and numerical correlation,respectively).CONCLUSION:MII-pH analysis confirmed GERD diagnosis in less than 40% of patients with previous diagnosis of LPR,most likely because of the low specificity of the laryngoscopic findings.展开更多
文摘目的探究复发性反流性食管炎采用富马酸伏诺拉生片治疗的临床疗效。方法拟将2020年11月—2022年4月收治的80例复发性反流性食管炎患者为研究对象,以随机数字表法为依据,分为两组,对照组患者采用奥美拉唑肠溶胶囊治疗,观察组采用富马酸伏诺拉生片治疗,两组患者均治疗8周,对比两组临床疗效、治疗前后胃肠激素指标[胃泌素(GAS)、血浆胃动素(MTL)]变化情况、症状改善情况、食管24 h pH监测结果、疾病复发情况。结果相较于对照组(67.50%),观察组(87.50%)治疗总有效率更高(P<0.05);相较于治疗前,两组治疗后各项症状评分均有所降低,且观察组低于对照组(P<0.05);相较于治疗前,两组治疗后GAS、MTL水平均有所提高,且观察组高于对照组(P<0.05);相较于治疗前,两组治疗后各项反流次数均有所减少,且观察组少于对照组(P<0.05);相较于对照组(17.50%),观察组(2.50%)的疾病复发率更低(P<0.05)。结论复发性反流性食管炎采用富马酸伏诺拉生片治疗的临床疗效显著,可改善临床症状与胃肠激素水平,减少反流次数,且疾病复发率低,具有良好的临床推广价值。
文摘AIM:To investigate the prevalence of gastroesophageal reflux disease(GERD) in patients with a laryngoscopic diagnosis of laryngopharyngeal reflux(LPR).METHODS:Between May 2011 and October 2011,41 consecutive patients with laryngopharyngeal symptoms(LPS) and laryngoscopic diagnosis of LPR were empirically treated with proton pump inhibitors(PPIs) for at least 8 wk,and the therapeutic outcome was assessed through validated questionnaires(GERD impact scale,GIS;visual analogue scale,VAS).LPR diagnosis was performed by ear,nose and throat specialists using the reflux finding score(RFS) and reflux symptom index(RSI).After a 16-d wash-out from PPIs,all patients underwent an upper endoscopy,stationary esophageal manometry,24-h multichannel intraluminal impedance and pH(MII-pH) esophageal monitoring.A positive correlation between LPR diagnosis and GERD was supposed based on the presence of esophagitis(ERD),pathological acid exposure time(AET) in the absence of esophageal erosions(NERD),and a positive correlation between symptoms and refluxes(hypersensitive esophagus,HE).RESULTS:The male/female ratio was 0.52(14/27),the mean age ± SD was 51.5 ± 12.7 years,and the mean body mass index was 25.7 ± 3.4 kg/m 2.All subjects reported one or more LPS.Twenty-five out of 41 patients also had typical GERD symptoms(heartburn and/or regurgitation).The most frequent laryngoscopic findings were posterior laryngeal hyperemia(38/41),linear indentation in the medial edge of the vocal fold(31/41),vocal fold nodules(6/41) and diffuse infraglottic oedema(25/41).The GIS analysis showed that 10/41 patients reported symptom relief with PPI therapy(P < 0.05);conversely,23/41 did not report any clinical improvement.At the same time,the VAS analysis showed a significant reduction in typical GERD symptoms after PPI therapy(P < 0.001).A significant reduction in LPS symptoms.On the other hand,such result was not recorded for LPS.Esophagitis was detected in 2/41 patients,and ineffective esophageal motility was found in 3/41 patients.The MII-pH analysis showed an abnormal AET in 5/41 patients(2 ERD and 3 NERD);11/41 patients had a normal AET and a positive association between symptoms and refluxes(HE),and 25/41 patients had a normal AET and a negative association between symptoms and refluxes(no GERD patients).It is noteworthy that HE patients had a positive association with typical GERD-related symptoms.Gas refluxes were found more frequently in patients with globus(29.7 ± 3.6) and hoarseness(21.5 ± 7.4) than in patients with heartburn or regurgitation(7.8 ± 6.2).Gas refluxes were positively associated with extraesophageal symptoms(P < 0.05).Overall,no differences were found among the three groups of patients in terms of the frequency of laryngeal signs.The proximal reflux was abnormal in patients with ERD/NERD only.The differences observed by means of MII-pH analysis among the three subgroups of patients(ERD/NERD,HE,no GERD) were not demonstrated with the RSI and RFS.Moreover,only the number of gas refluxes was found to have a significant association with the RFS(P = 0.028 andP = 0.026,nominal and numerical correlation,respectively).CONCLUSION:MII-pH analysis confirmed GERD diagnosis in less than 40% of patients with previous diagnosis of LPR,most likely because of the low specificity of the laryngoscopic findings.
