胃肠病学
胃腸病學
위장병학
CHINESE JOURNAL OF GASTROENTEROLOGY
2014年
12期
725-729
,共5页
难治性胃食管反流病%巴氯芬%埃索美拉唑%莫沙必利%治疗
難治性胃食管反流病%巴氯芬%埃索美拉唑%莫沙必利%治療
난치성위식관반류병%파록분%애색미랍서%막사필리%치료
Refractory Gastroesophageal Reflux Disease%Baclofen%Esomeprazole%Mosapride%Therapy
背景：对常规剂量质子泵抑制剂治疗无反应的胃食管反流病（ GERD）称为难治性胃食管反流病（ rGERD），国内主要联合多种药物治疗rGERD患者，但巴氯芬的报道较少见。目的：探讨巴氯芬联合埃索美拉唑和莫沙必利治疗rGERD的疗效。方法：纳入2013年3月-2014年4月福建省莆田市第一医院72例rGERD患者，随机分为两组。A组患者口服埃索美拉唑20 mg bid +莫沙必利5 mg tid +巴氯芬5 mg tid；B组口服埃索美拉唑20 mg bid +莫沙必利5 mg tid，疗程均为8周。比较两组症状、内镜下食管炎改善情况和不良反应。结果：治疗8周后，两组烧心、反酸、胸骨后疼痛、吞咽困难、症状总计分均较治疗前显著降低（ P﹤0.05），A组症状改善总有效率显著高于 B组（90.6%对70.0%；χ2=4.585，P=0.032）。两组内镜下食管炎分级情况明显改善，A组内镜下治疗有效率显著高于B组（93.8%对75.0%；χ2=4.500，P=0.034）。巴氯芬的主要不良反应为嗜睡、头晕和乏力，患者均能耐受。结论：巴氯芬联合埃索美拉唑和莫沙必利是一种有效治疗rGERD的方法。
揹景：對常規劑量質子泵抑製劑治療無反應的胃食管反流病（ GERD）稱為難治性胃食管反流病（ rGERD），國內主要聯閤多種藥物治療rGERD患者，但巴氯芬的報道較少見。目的：探討巴氯芬聯閤埃索美拉唑和莫沙必利治療rGERD的療效。方法：納入2013年3月-2014年4月福建省莆田市第一醫院72例rGERD患者，隨機分為兩組。A組患者口服埃索美拉唑20 mg bid +莫沙必利5 mg tid +巴氯芬5 mg tid；B組口服埃索美拉唑20 mg bid +莫沙必利5 mg tid，療程均為8週。比較兩組癥狀、內鏡下食管炎改善情況和不良反應。結果：治療8週後，兩組燒心、反痠、胸骨後疼痛、吞嚥睏難、癥狀總計分均較治療前顯著降低（ P﹤0.05），A組癥狀改善總有效率顯著高于 B組（90.6%對70.0%；χ2=4.585，P=0.032）。兩組內鏡下食管炎分級情況明顯改善，A組內鏡下治療有效率顯著高于B組（93.8%對75.0%；χ2=4.500，P=0.034）。巴氯芬的主要不良反應為嗜睡、頭暈和乏力，患者均能耐受。結論：巴氯芬聯閤埃索美拉唑和莫沙必利是一種有效治療rGERD的方法。
배경：대상규제량질자빙억제제치료무반응적위식관반류병（ GERD）칭위난치성위식관반류병（ rGERD），국내주요연합다충약물치료rGERD환자，단파록분적보도교소견。목적：탐토파록분연합애색미랍서화막사필리치료rGERD적료효。방법：납입2013년3월-2014년4월복건성보전시제일의원72례rGERD환자，수궤분위량조。A조환자구복애색미랍서20 mg bid +막사필리5 mg tid +파록분5 mg tid；B조구복애색미랍서20 mg bid +막사필리5 mg tid，료정균위8주。비교량조증상、내경하식관염개선정황화불량반응。결과：치료8주후，량조소심、반산、흉골후동통、탄인곤난、증상총계분균교치료전현저강저（ P﹤0.05），A조증상개선총유효솔현저고우 B조（90.6%대70.0%；χ2=4.585，P=0.032）。량조내경하식관염분급정황명현개선，A조내경하치료유효솔현저고우B조（93.8%대75.0%；χ2=4.500，P=0.034）。파록분적주요불량반응위기수、두훈화핍력，환자균능내수。결론：파록분연합애색미랍서화막사필리시일충유효치료rGERD적방법。
Background:Gastroesophageal reflux disease( GERD)that does not respond satisfactorily to standard proton pump inhibitor is defined as refractory gastroesophageal reflux disease( rGERD). Combined therapy is used to treat rGERD, however,the addition of baclofen is rarely studied. Aims:To investigate the efficacy of baclofen combined with esomeprazole and mosapride on rGERD. Methods:Seventy-two patients with rGERD from March 2013 to April 2014 at the First Hospital of Putian City were enrolled and randomly divided into group A and group B. Patients in group A were orally administrated with esomeprazole 20 mg bid + mosapride 5 mg tid + baclofen 5 mg tid. Patients in group B were treated with esomeprazole 20 mg bid + mosapride 5 mg tid. The treatment course was 8 weeks. The efficacy on symptoms, esophagitis under endoscopy and adverse effects were compared between the two groups. Results:After 8-week treatment, score of heartburn,regurgitation,retrosternal pain,dysphagia and overall symptom were significantly decreased in the two groups than before the treatment. The overall symptom alleviating rate was significantly higher in group A than in group B (90. 6% us. 70. 0%;χ2 =4. 585,P=0. 032). Esophagitis under endoscopy in the two groups was significantly improved, the effective rate was significantly higher in group A than in group B(93. 8% us. 75. 0%;χ2 =4. 500,P=0. 034). The main adverse effects of baclofen were somnolence,dizziness and fatigue,all the patients were well tolerated. Conclusions:Baclofen combined with esomeprazole and mosapride is an efficient option for rGERD.
