Therapeutic effect of Wendan Decoction combined with mosapride on gastroesophageal reflux disease after esophageal cancer surgery

BACKGROUND Gastroesophageal reflux disease(GERD)is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage.Wendan Decoction(WDD)is a traditional Chinese herbal formula used to treat various gastrointestinal disorders,such as gastritis,functional dyspepsia,and irritable bowel syndrome.Mosapride,a prokinetic agent,functions as a selective 5-hydroxytryptamine 4 agonist,enhancing gastrointestinal motility.AIM To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.METHODS Eighty patients with GERD were randomly divided into treatment(receiving WDD combined with mosapride)and control(receiving mosapride alone)groups.The treatment was conducted from January 2021 to January 2023.The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire(RDQ).The secondary outcomes were improved esophageal motility(measured using esophageal manometry),gastric emptying(measured using gastric scintigraphy),and quality of life[measured via the Short Form-36(SF-36)Health Survey].RESULTS The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters,such as lower esophageal sphincter pressure,peristaltic amplitude,and peristaltic velocity compared to the control group.The treatment group showed significantly higher gastric emptying rates and SF-36 scores(in both physical and mental domains)compared to the control group.No serious adverse effects were observed in either group.CONCLUSION WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery.It can improve GERD symptoms,esophageal motility,gastric emptying,and the quality of life of patients.Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.

Endoscopic full-thickness plication along with argon plasma coagulation for treatment of proton pump inhibitor dependent gastroesophageal reflux disease

BACKGROUND Most endoscopic anti-reflux interventions for gastroesophageal reflux disease(GERD)management are technically challenging to practice with inadequate data to support it utility.Therefore,this study was carried to evaluate the effectiveness and safety newer endoscopic full-thickness fundoplication(EFTP)device along with Argon Plasma Coagulation to treat individuals with GERD.AIM To evaluate the effectiveness and safety newer EFTP device along with Argon Plasma Coagulation to treat individuals with GERD.METHODS This study was a single-center comparative analysis conducted on patients treated at a Noble Institute of Gastroenterology,Ahmedabad,hospital between 2020 and 2022.The research aimed to retrospectively analyze patient data on GERD symptoms and proton pump inhibitor(PPI)dependence who underwent EFTP using the GERD-X system along with argon plasma coagulation(APC).The primary endpoint was the mean change in the total gastroesophageal reflux disease health-related quality of life(GERD-HRQL)score compared to the baseline measurement at the 3-month follow-up.Secondary endpoints encompassed enhancements in the overall GERD-HRQL score,improvements in GERD symptom scores at the 3 and changes in PPI usage at the 3 and 12-month time points.RESULTS In this study,patients most were in Hill Class II,and over half had ineffective esophageal motility.Following the EFTP procedure,there were significant improvements in heartburn and regurgitation scores,as well as GERDHRQL scores(P<0.001).PPI use significantly decreased,with 82.6%not needing PPIs or prokinetics at end of 1 year.No significant adverse events related to the procedures were observed in either group.CONCLUSION The EFTP along with APC procedure shows promise in addressing GERD symptoms and improving patients'quality of life,particularly for suitable candidates.Moreover,the application of a lone clip with APC yielded superior outcomes and exhibited greater cost-effectiveness.

Disagreement between symptom-reflux association analysis parameters in pediatric gastroesophageal reflux disease investigation

AIM: To assess the agreement within 3 commonly used symptom-reflux association analysis (SAA) parameters investigating gastroesophageal reflux disease (GERD) in infants. METHODS: Twenty three infants with suspected GERD were included in this study. Symptom index (SI), Symptom sensitivity index (SSI) and symptom association probability (SAP) related to cough and irritability were calculated after 24 h combined pH/multiple intraluminal impedance (MII) monitoring. Through defined cutoff values, SI, SSI and SAP values are differentiated in normal and abnormal, whereas abnormal values point towards gastroesophageal reflux (GER) as the origin of symptoms. We analyzed the correlation and the concordance of the diagnostic classification of these 3 SAA parameters.RESULTS: Evaluating the GER-irritability association, SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 39.2% of the infants. When irritability was taken as a symptom, there was only a poor inter-parameter association between SI and SSI, and between SI and SAP (Kendall’s tau b = 0.37, P < 0.05; Kendall’s tau b = 0.36, P < 0.05, respectively). Evaluating the GER-cough association, SI, SSI and SAP showed non-identical classification of normal and abnormal cases in 52.2% of the patients. When cough was taken as a symptom, only SI and SSI showed a poor inter-parameter association (Kendall’s tau b = 0.33, P < 0.05). CONCLUSION: In infants investigated for suspected GERD with pH/MII-monitoring, SI, SSI and SAP showed a poor inter-parameter association and important dis-agreements in diagnostic classification. These limitations must be taken into consideration when interpreting the results of SAA in infants.

Non-erosive and uncomplicated erosive reflux diseases:Difference in physiopathological and symptom pattern

AIM:To investigate differences in the physiopathological findings(manometry and pH monitoring) and symptoms between cases of non-erosive reflux disease(NERD) and erosive reflux disease(ERD) found positive at 24 h pH monitoring. METHODS:For a total of 670 patients who underwent 24 h pH monitoring,esophageal manometry and upper endoscopy were retrospectively evaluated,assessing the reflux symptoms,manometric characteristics of the lower esophageal sphincter(LES) and esophageal body and the presence or absence of esophagitis and hiatal hernia. Typical and atypical symptoms were also evaluated. For inclusion in the study,patients had to have NERD or ERD and be found positive on pH monitoring(NERD+) . Patients with Gastroesophageal reflux disease(GERD) complicated by stenosis,ulcers or Barrett's esophagus were ruled out. RESULTS:214 patients were involved in the study,i.e. 107 cases of NERD+ and 107 of ERD. There were no significant gender-or age-related differences between the two groups. The ERD group had more cases of hiatal hernia(P = 0.02) and more acid reflux,both in terms of number of reflux episodes(P = 0.01) and as a percentage of the total time with a pH < 4(P = 0.00) ,when upright(P = 0.007) and supine(P = 0.00) . The NERD+ cases had more reflux episodes while upright(P = 0.02) and the ERD cases while supine(P = 0.01) . The LES pressure was higher in cases of NERD+(P = 0.03) while the amplitude and duration of their esophageal peristaltic waves tended to be better than in the ERD group(P >0.05) . The NERD+ patients presented more often with atypical symptoms(P = 0.01) . CONCLUSION:The NERD+ patients' fewer reflux episodes and the fact that they occurred mainly while in the upright position(unlike the cases of ERD) may be two factors that do not favor the onset of esophagitis. The frequently atypical symptoms seen in patients with NERD+ need to be accurately evaluated for therapeutic purposes because patients with GERD and atypical symptoms generally respond only partially to medical and surgical treatments.

Japanese apricot improves symptoms of gastrointestinal dysmotility associated with gastroesophageal reflux disease

AIM: To investigate the effects of Japanese apricot(JA) consumption on gastroesophageal reflux disease(GERD)-related symptoms.METHODS: Participants included individuals living in Minabe-cho,a well-known JA-growing region,who received specific medical check-ups by the local community health service in 2010.GERD-related symptoms were examined in 1303 Japanese individuals using a validated questionnaire,the Frequency Scale for Symptoms of GERD(FSSG),which consists of 7 questions associated with acid reflux symptoms and 5 questions asking about gastrointestinal dysmotility symptoms.Each question was answered using a 4-point scale,with higher scores indicating more severe GERDrelated symptoms.Subjects were divided into two groups according to their intake of dried and pickled JA: daily intake(≥ 1 JA daily)(392 subjects) and none oroccasional intake(< 1 JA daily)(911 subjects).FSSG scores were compared between subjects who consumed JA daily and those who did not.Next,subjects were stratified by age,gender and Helicobacter pylori(H.pylori) status for subanalyses.RESULTS: Those who ate JA daily were significantly older than those who did not(60.6 ± 10.5 years vs 56.0 ± 11.0 years,P < 0.001).Total FSSG scores were significantly lower in subjects with daily JA intake than in those with none or only occasional intake(2.13 ± 3.14 vs 2.70 ± 3.82,P = 0.005).In particular,subjects who consumed JA daily showed significantly improved FSSG dysmotility scores compared with subjects who did not(1.05 ± 1.58 vs 1.46 ± 2.11,P < 0.001).In contrast,the FSSG reflux score did not differ between subjects with and without daily intake of JA(1.08 ± 1.90 vs 1.24 ± 2.11,P = 0.177).Subanalysis indicated that improvement in dysmotility by JA intake was specifically observed in non-elderly(1.24 ± 1.68 vs 1.62 ± 2.22,P = 0.005) and H.pylori-negative subjects(0.99 ± 1.58 vs 1.57 ± 2.06,P < 0.001).GERD patients(total FSSG score ≥ 8) were less frequently observed among subjects with daily intake of JA as compared to those without daily intake of JA(6.1% vs 9.7%,P = 0.040).CONCLUSION: Daily JA intake may improve digestive dysmotility symptoms,resulting in relief of GERD symptoms.The effect is more obvious in non-elderly and H.pylori-negative subjects.

Factors associated with residual gastroesophageal reflux disease symptoms in patients receiving proton pump inhibitor maintenance therapy

AIM To elucidate the factors associated with residual gastroesophageal reflux disease(GERD) symptoms in patients receiving proton pump inhibitor(PPI) maintenance therapy in clinical practice.METHODS The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD(FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale(GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed.RESULTS The FSSG scores ranged from 1 to 28 points(median score: 7.5 points), and 19 patients(48.7%) had a score of 8 points or more. The patients' GSRS scores were significantly correlated with their FSSG scores(correlation coefficient = 0.47, P < 0.005). In erosive esophagitis patients, the FSSG scores of the CYP2C19 rapid metabolizers(RMs) were significantly higher than the scores of the poor metabolizers and intermediate metabolizers(total scores: 16.7 ± 8.6 vs 7.8 ± 5.4, P < 0.05; acid reflux-related symptom scores: 12 ± 1.9 vs 2.5 ± 0.8, P < 0.005). In contrast, the FSSG scores of the CYP2C19 RMs in the non-erosive reflux disease patients were significantly lower than those of the other patients(total scores: 5.5 ± 1.0 vs 11.8 ± 6.3, P < 0.05; dysmotility symptom-related scores: 1.0 ± 0.4 vs 6.0 ± 0.8, P < 0.01). CONCLUSION Approximately half of the GERD patients receiving maintenance PPI therapy had residual symptoms associated with a lower quality of life, and the CYP2C19 genotype appeared to be associated with these residual symptoms.

蒲元和胃胶囊联合雷贝拉唑治疗反流性食管炎的临床评价

目的 观察蒲元和胃胶囊联合雷贝拉唑治疗反流性食管炎的作用。方法 纳入河南大学第一附属医院胸外科2022年6月至2024年1月收治的102例反流性食管炎患者,以随机数字表法分成观察组(51例)与对照组(51例),给予对照组患者雷贝拉唑治疗,给予观察组患者蒲元和胃胶囊联合雷贝拉唑治疗,对比2组临床疗效、上腹痛、反酸与嗳气症状缓解时间、治疗前后反流性疾病问卷(RDQ)评分及胃动素、胃泌素水平以及不良反应情况。结果 观察组总有效率(96.08%)比对照组(84.31%)更高(χ^(2)=3.991,P<0.05);观察组患者的上腹痛、反酸与嗳气症状缓解时间分别为(6.15±0.52) d、(5.80±0.52) d、(5.52±0.38) d,均分别短于对照组患者(8.44±0.73) d、(7.38±0.66) d、(6.72±0.82) d,t=18.247、13.429、9.482,P<0.001;观察组患者治疗后症状发作频率评分为(3.99±0.52)分,症状发作程度评分为(5.48±0.69)分,均短于对照组治疗后评分(6.24±0.67)分、(7.42±0.72)分,t=18.946、13.893,P<0.001;观察组患者治疗后胃动素、胃泌素水平分别为(331.29±4.92) ng·L^(-1)、(178.54±4.37) pg·m L^(-1),均高于对照组(299.54±5.23) ng·L^(-1)、(143.25±4.92) pg·m L^(-1),t=31.577,P<0.001;观察组(3.92%)与对照组不良反应率(5.88%)差异无统计学意义,χ^(2)=0.210,P>0.05。结论 蒲元和胃胶囊结合雷贝拉唑治疗反流性食管炎效果良好,患者症状缓解快,胃肠功能恢复良好,治疗不良反应较少,值得应用。

无痛胃镜检查术后咽喉疼痛的发生情况和危险因素分析

目的探讨无痛胃镜检查术后咽喉疼痛的发生情况及其危险因素。方法选取2019年10月-2019年11月于该院内镜中心接受无痛胃镜检查术的连续门诊患者作为研究对象。采用课题组自行编订的调查问卷收集相关信息,从无痛胃镜检查术后24 h开始,每隔24 h进行一次电话随访,直至术后咽喉疼痛完全消失;采用数字分级评分法(NRS)评估术后咽喉疼痛严重程度,并记录持续时间;根据是否出现术后咽喉疼痛,将患者分为术后咽喉疼痛组(Ⅰ组)和非术后咽喉疼痛组(Ⅱ组),将两组组间比较差异有统计学意义的因素纳入多因素Logistic回归分析,筛选影响无痛胃镜检查术患者术后咽喉疼痛的独立危险因素。结果共608例患者完成研究,42例发生术后咽喉疼痛,发生率为6.91%,NRS评分为3.00(2.00,4.25)分,持续时间为24.0(10.0,48.0)h,最长时间为192 h(1例)。年龄及前3天疲劳程度是无痛胃镜检查术患者术后咽喉疼痛的独立影响因素:年龄每增加1岁,术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是术后咽喉疼痛的危险因素。结论无痛胃镜检查术后咽喉疼痛问题值得高度重视。年龄每增加1岁,无痛胃镜检查术后咽喉疼痛发生率减少2.60%;前3天疲劳程度为中度疲劳和重度疲劳,是无痛胃镜检查术后咽喉疼痛的危险因素。

清热散结胶囊联合开喉剑喷雾剂治疗反流性咽喉炎的价值

目的探讨清热散结胶囊联合开喉剑喷雾剂治疗对反流性咽喉炎声嘶症状以及反流症状指数评分量表(reflux symptom index,RSI)评分和反流体征指数评分(reflux findings score,RFS)的影响。方法选取丽水市人民医院2020年1月—2022年1月收治的90例反流性咽喉炎患者作为研究对象,按照随机数字表法分为观察组45例(给予清热散结胶囊联合开喉剑喷雾剂治疗)和对照组45例(给予清热散结胶囊治疗)。观察治疗后的临床疗效,症状积分,胃蛋白酶水平,炎症因子水平,RSI、RFS评分。结果治疗后,观察组患者的显效率为60.00%(27/45),高于对照组患者的35.56%(16/45)(P<0.05)。治疗后,观察组咳嗽、声嘶、吞咽困难、反酸烧心、咽喉黏滞等症状积分均低于对照组患者(P<0.05)。治疗前,两组患者的胃蛋白酶水平比较,差异无统计学意义(P>0.05);治疗后3 d、7 d,观察组患者的胃蛋白酶水平分别低于对照组患者(P<0.05)。治疗前,两组患者白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)值比较,差异无统计学意义(P>0.05);治疗后7 d,观察组患者的IL-6、TNF-α值均低于对照组患者(P<0.05)。治疗前,两组患者RSI评分和RFS评分比较,差异无统计学意义(P>0.05);治疗后7 d,观察组患者的RSI评分和RFS评分均低于对照组患者(P<0.05)。结论清热散结胶囊联合开喉剑喷雾剂能够提高反流性咽喉炎患者的临床疗效,降低患者症状积分,改善胃蛋白酶水平,降低炎症因子水平以及改善反流症状与反流体征,值得临床推广。

虎符铜砭刮痧联合PDCA循环护理在胃食管反流病患者中的应用

目的探讨对胃食管反流病患者实施虎符铜砭刮痧结合PDCA循环护理的效果。方法选择2020年6月至2022年6月期间南京市中医院收治的150例胃食管反流病患者,根据数字随机法将其分为对照组和观察组,每组75例。对照组给予PDCA循环护理进行干预,观察组给予PDCA循环护理结合虎符铜砭刮痧进行干预。比较2组患者干预前后的护理效果。结果干预4周及8周后,观察组的焦虑自评量表、抑郁自评量表和反流性疾病问卷评分均低于对照组,健康状况调查问卷评分均高于对照组(P均<0.05);干预4周及8周后,观察组的肿瘤坏死因子-α和超敏C反应蛋白水平均低于对照组,胃动素和胃泌素水平均高于对照组(P均<0.05);干预8周后,2组的上述评分和指标均优于干预前及干预4周后(P均<0.05)。结论对胃食管反流病患者应用虎符铜砭刮痧联合PDCA循环护理进行干预,能够有效缓解患者的临床症状和心理状态,改善其血清炎症因子和胃肠激素水平,且提升其生活质量。

Eye reflux:an ocular extraesophageal manifestation of gastric reflux

AIM： To suspect laryngopharyngeal reflux（LPR） in patients with ocular surface disease（OSD）. METHODS： The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index（OSDI） and the Reflux Symptom Index（RSI） to detect patients with suspected LPR and define a possible relationship between tests.RESULTS： Two hundred and ninety subjects（175 females, mean age： 60.41±15.68y） were consecutively visited at ophthalmologist offices. One hundred and one（34%） patients had pathological RSI（〉13） and consequently a suspected LPR.CONCLUSION： The current study shows that suspected LPR may be common（34%） in patients with OSD and a suspected LPR may be considered in OSD patients when RSI score is 〉13 and OSDI score is 〉42.

胃食管反流样症状患者质子泵抑制剂使用的规范性与合理性分析

目的分析消化内科门诊胃食管反流样症状患者口服质子泵抑制剂(PPIs)的规范性与合理性,为临床提供参考。方法选取2017年7月1日~2022年12月31日消化内科门诊以胃食管反流样症状为主诉且完善内镜检查及食管24 h pH值监测的患者200例,统计患者PPIs的使用情况,分析PPIs用药的合理性和规范性。结果200例患者中,使用PPIs患者有182例,其中102例(56.04%)患者长期服用PPIs时间超过3个月,服用的PPIs中以雷贝拉唑钠肠溶胶囊占比较重,其次为奥美拉唑肠溶胶囊、艾司奥美拉唑肠溶胶囊、泮托拉唑钠肠溶胶囊、兰索拉唑肠溶片;182例患者中有111例不合理用药者(占比60.99%),包括71例预防用药不合理者(占比39.01%)和40例治疗用药不合理者(占比21.98%);111例不合理用药的症状分布中以反流、烧心为主要症状的有63例,占比较重,为56.76%,其次为胸骨后不适、嗳气、腹痛、咳嗽等相关症状;182例使用过PPIs患者中,幽门螺杆菌感染者有74例(40.66%),仅12例(6.59%)在服用PPIs前进行了^(13)C呼气试验的检测,明确了有无幽门螺杆菌感染。结论某院普遍存在PPIs药物不合理应用现象,因此,应加强PPIs的科普与规范化使用。

双指数导向干预联合5A早期康复护理在甲状腺癌手术患者中的应用

目的探讨在甲状腺癌手术患者中应用双指数导向干预联合5A早期康复护理的效果。方法选取该院2018年7月—2023年6月行手术治疗的80例甲状腺癌患者为研究对象,采用随机数字表法将其分为对照组和干预组。对照组(n=40)采用常规护理,干预组(n=40)采用双指数导向干预联合5A早期康复护理。比较两组的嗓音障碍程度、咽喉反流症状程度、自我护理能力。结果干预后,干预组嗓音障碍指数评分为(12.48±3.45)分,低于对照组的(15.52±4.07)分,差异有统计学意义(P<0.05)。干预组咽喉反流症状指数评分为(8.13±2.31)分,低于对照组的(12.36±3.28)分,差异有统计学意义(P<0.05)。干预组自我护理能力量表评分高于对照组,差异有统计学意义(P<0.05)。结论双指数导向干预联合5A早期康复护理应用于甲状腺癌手术患者干预中,能够改善患者嗓音障碍程度、咽喉反流症状程度,提高自我护理能力。

腹式深呼吸训练用于胃食管反流病患者的价值观察

目的探讨腹式深呼吸训练应用于胃食管反流病患者中的价值。方法选取2022年1月—2023年1月淄博一四八医院收治的胃食管反流病患者76例,采取奇偶分组法分为2组,各38例。参照组选择常规干预模式,试验组以参照组治疗方案为前提,结合腹式深呼吸训练方案。对2组干预效果进行评定。结果干预后,试验组焦虑抑郁程度低于参照组,生活质量评分高于参照组(P<0.05)。试验组干预后反酸评分为(1.12±0.13)分,低于参照组的(2.26±0.21)分(P<0.05)。试验组其余反流性疾病问卷评分低于参照组(P<0.05)。结论腹式深呼吸训练的应用有助于加快胃食管反流病患者症状的改善速度。同时,此种干预形式对缓解患者症状、提高其生活质量作用突出。

基于脾-线粒体相关性探讨ICC功能障碍

功能性胃肠病(Functional gastrointestinal disorders,FGIDs)症状重叠常常存在病情错综复杂、临床中诊疗困难、易加重患者的心理、经济负担及造成相应的医疗资源的消耗等现状。研究发现,功能性消化不良(Functional dyspepsia,FD)和胃食管反流病(Gastroesophageal reflux disease,GERD)可能存在潜在的病理生理学联系,目前主要认为与食管下括约肌松弛及胃排空延迟所致胃肠道动力障碍有关。脾为后天之本,气血生化之源,布散精微于周身,蕴含机体所需能量及物质。线粒体有“动力工厂”之称,通过三羧酸循环及氧化磷酸化生成ATP为机体生命活动提供能量的同时还可以生成血红素。脾与线粒体的功能体现了相同生命活动的两种不同诠释方式。相关研究认为,辨证为脾虚时线粒体能量代谢障碍所致的Cajal间质细胞(Interstitial cells of Cajal,ICC)功能障碍与胃肠动力障碍关系密切。故本文基于“脾与线粒体”相关性,探讨ICC功能障碍与FD-GERD症状重叠的关系,提出脾虚与线粒体能量代谢障碍引发ICC功能障碍是造成FDGERD症状重叠的重要因素。除此之外,从通降理论入手,可以为诊治FD-GERD症状重叠提供较高的临床实用价值。

兰索拉唑联合度洛西汀治疗对胃食管反流病患者症状和生活质量的影响

目的 胃食管反流病(GERD)会对患者身心健康产生不良反应,分析兰索拉唑联合度洛西汀治疗方案的应用效果。方法 50例GERD患者,以随机数字表法分为对照组与研究组,每组25例。对照组采用兰索拉唑治疗,研究组在对照组基础上联合度洛西汀治疗。对比两组不良情绪与症状、食管远端平滑肌运动功能、生活质量。结果 治疗后,两组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、胃食管反流病自测量表(GerdQ)评分均低于本组治疗前,且研究组HAMA评分(6.37±1.41)分、HAMD评分(10.28±0.41)分、GerdQ评分(5.37±0.49)分低于对照组的(9.27±2.05)、(13.27±0.62)、(9.25±2.41)分(P<0.05)。治疗后,两组食管下括约肌静息压(LESP)、下括约肌松弛率(LESRR)、远端收缩积分(DCI)均高于本组治疗前;且研究组食管LESP、LESRR、DCI分别为(20.26±1.89)mm Hg(1 mm Hg=0.133 kPa)、(99.37±8.14)%、(425.39±95.42)mm Hg·s·cm,高于对照组的(17.13±1.12)mm Hg、(90.27±7.46)%、(299.25±92.34)mm Hg·s·cm(P<0.05)。治疗后,两组烧心、吞咽、药物影响、一般健康状态评分均低于本组治疗前;且研究组烧心、吞咽、药物影响、一般健康状态评分分别为(2.19±0.11)、(2.19±0.37)、(2.35±0.15)、(2.38±0.16)分,低于对照组的(5.73±1.42)、(5.93±0.64)、(4.96±1.41)、(4.83±0.43)分(P<0.05)。结论 GERD患者不仅有躯体表现症状,且患者的心理状态也受到影响,应用兰索拉唑联合度洛西汀治疗方案有利于促进病情转归,改善患者不良情绪、生活质量,具有较高的临床应用价值,值得推广。

西酞普兰结合泮托拉唑和伊托必利治疗反流性食管炎的效果及对患者临床症状的影响

目的分析西酞普兰结合泮托拉唑和伊托必利治疗反流性食管炎(RE)的效果。方法选取2020年3月至2022年3月我院收治的100例RE患者为研究对象,以随机数字表法将其为对照组和观察组,各50例。两组患者在住院期间均需要采取对症治疗,在此基础上,对照组采取泮托拉唑和伊托必利治疗,观察组采取西酞普兰结合泮托拉唑和伊托必利治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的胃动素水平高于对照组,胃泌素及白细胞介素-17(IL-17)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的反酸、胸骨后烧痛及烧心积分均低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论西酞普兰结合泮托拉唑和伊托必利治疗RE取得了理想的应用效果,能够缓解患者的焦虑、抑郁情绪,减轻心理因素对治疗的影响,可以提高临床疗效,显著改善临床症状,并且具有较高的用药安全性,值得临床推广。

双歧杆菌三联活菌联合四联疗法治疗幽门螺杆菌阳性胃食管反流患者的效果

目的:观察双歧杆菌三联活菌联合四联疗法治疗幽门螺杆菌(Hp)阳性胃食管反流患者的效果。方法:选取2020年6月至2023年4月该院收治的200例Hp阳性胃食管反流患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各100例。对照组采用四联疗法治疗,研究组在对照组基础上联合双歧杆菌三联活菌治疗,比较两组临床疗效、Hp根除率、治疗前后临床症状评分、胃功能[胃蛋白酶原I(PGI)、胃泌素-17(G-17)]水平和食管括约肌压力[上食管括约肌(UES)、下食管括约肌(LES)静息压]水平及不良反应发生率。结果:研究组治疗总有效率为95.00%(95/100),高于对照组的85.00%(85/100),差异有统计学意义(P<0.05);研究组Hp根除率为93.00%(93/100),高于对照组的82.00%(82/100),差异有统计学意义(P<0.05);治疗后,两组临床症状评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组PGI、G-17水平和UES、LES静息压均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:双歧杆菌三联活菌联合四联疗法治疗Hp阳性胃食管反流患者,可提高临床疗效和Hp根除率,改善胃功能和食管括约肌压力,效果优于单纯四联疗法治疗。

三仁汤合旋覆代赭汤治疗胃食管反流病72例临床研究

目的:探讨三仁汤合旋覆代赭汤加减治疗胃食管反流病(Gastroesophageal Reflux Disease,GERD)的临床疗效及对中医证候积分、GERD主要症状积分、不良反应、复发率及患者满意度等的影响。方法:研究对象选取2022年1月―2023年1月福建中医药大学附属第三人民医院脾胃病科及脾胃科门诊收治的GERD患者72例,根据随机数字表法分成治疗组(36例)和对照组(36例)。其中对照组给予富马酸伏诺拉生片方案治疗,治疗组在对照组基础上给予口服中药三仁汤合旋覆代赭汤加减治疗,两组均持续治疗4周。比较治疗前后两组中医证候积分、主要症状积分、复发率、患者满意度等,并对其疗效及安全性进行记录。结果:治疗前两组中医证候积分、主要临床症状积分(反酸、烧心)比较,差异无统计学意义(P>0.05),治疗后两组中医证候积分均有改善(P<0.05),且治疗组改善效果优于对照组(P<0.05);两组治疗后在GERD的主要症状反酸、烧心方面均有显著改善作用,且治疗组在改善烧心症状方面优于对照组(P<0.05);临床总有效率方面,治疗组优于对照组,差异有统计学意义(P<0.05);不良反应发生率方面,治疗组低于对照组,但差异无统计学意义(P>0.05);疾病复发率上,随访调查治疗后3个月患者,显示治疗组复发率低于对照组,差异有统计学意义(P<0.05);治疗组患者满意度优于对照组,差异有统计学意义(P<0.05)。结论:三仁汤合旋覆代赭汤加减治疗GERD,能有效缓解其症状,尤其在烧心主要症状方面更加显著,调节胃肠功能作用,减少复发,提高生活质量,相比常规治疗临床疗效更显著,安全性也更好。

Pulmonary or otolaryngologic extraesophageal manifestations in patients with gastroesophageal reflux disease

The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux.