膈肌生物反馈训练治疗胃食管反流病的疗效观察

发布时间：2018-06-06 22:45

本文选题：胃食管反流病 + 食管下括约肌　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：通过观察膈肌生物反馈训练(Diaphragm boifeedback training DBT)对食管下括约肌静息压、静息膈脚张力、最大膈脚张力以及对GerdQ (Gastroesophageal reflux disease question胃食管反流病问卷)评分的影响,观察DBT对GERD (Gastroesophageal reflux disease胃食管反流病)的改善状况,以及对降低GERD复发的影响,以此探讨DBT对GERD的疗效。方法：将60例初始确诊GERD的患者随机分为3组,每组20例,第1组为PPI(proton pump inhibitor,质子泵抑制剂)+DBT组、第2组为PPI组,第3组为DBT组。PPI+DBT组生物反馈治疗15分钟2/日+雷贝拉唑肠溶胶囊20mg1/日口服；PPI组雷贝拉唑肠溶胶囊20mg1/日口服；DBT组生物反馈治疗15分钟2/日。分别于治疗前、2周后及4周后对三组患者进行下食管括约肌静息压、静息膈脚张力、最大膈脚张力检测,行GerdQ评分。治疗4周后前两组患者停用药物,第1组及第3组患者继续坚持DBT治疗,在8周时再次检测上述指标并行GerdQ评分,评价复发情况。结果：DBT组及PPI+DBT组患者食管下括约肌静息压、静息膈脚张力、最大膈脚张力在治疗2周后、4周后均有提高,其中静息膈脚张力的变化有统计学意义(P0.05)。三组患者在治疗2周末、4周末GerdQ评分均有明显下降,PPI+DBT下降更为显著,PPI+DBT组与PPI组间比较,差异有统计学意义,(P0.05)。8周后PPI+DBT组及DBT组患者的静息膈脚张力、GerdQ评分与PPI组之间比较差异均有统计学意义(P0.05)。PPI组食管下括约肌静息压、静息膈脚张力、最大膈脚张力在治疗2周后、4周后均无明显变化(P0.05)。结论：生物反馈训练治疗,可以提高GERD患者静息膈脚张力,明显改善患者阳性症状,进而提高GERD患者疗效。在患者的后期治疗中有望替代PPI药物而成为巩固疗效的一种有效治疗方法。
[Abstract]:Objective: to observe the effects of diaphragm biofeedback training on resting pressure of lower esophageal sphincter, resting phrenic foot tension, maximum phrenic foot tension and the score of GerdQ Gastroesophageal reflux disease question gastroesophageal reflux disease (GERD). To observe the effect of reflux disease on gastroesophageal reflux disease (GERD) and to reduce the recurrence of GERD, 60 patients with GERD were randomly divided into 3 groups, 20 cases in each group. The first group was PPIproton pump inhibitor (proton pump inhibitor) DBT, and the second group was PPI group. The third group was treated with biofeedback for 15 minutes, 2 minutes / day, 2 minutes, 2 minutes and 2 days respectively in group 3. The rats in group 3 were treated with rabeprazole enteric-coated capsule 20mg1/ for 15 minutes and 2 days after oral administration of Rabeprazole enteric-coated capsule 20mg1/. The resting pressure of lower esophageal sphincter, resting phrenic foot tension and maximal phrenic foot tension were measured 2 weeks before treatment and 4 weeks after treatment. GerdQ score was used. After 4 weeks of treatment, the patients in the first two groups stopped taking drugs, and the patients in the first and third groups continued to be treated with DBT. After 8 weeks of treatment, the above indexes were measured again with GerdQ score to evaluate the recurrence. Results the resting pressure of the lower esophageal sphincter was evaluated in the group of 20 DBT and the group of PPI DBT. The resting phrenic foot tension and the maximum phrenic foot tension increased after 2 weeks and 4 weeks after treatment, among which the change of resting phrenic foot tension was statistically significant (P 0.05). The GerdQ scores of the three groups were significantly decreased at the end of 2 weeks and 4 weeks after treatment. The decrease of PPI DBT was more significant than that of PPI DBT group and PPI DBT group. There were significant differences in the resting phrenic foot tension and GerdQ score between PPI DBT group and DBT group and between PPI group and PPI group after P0.05.8 weeks. There were significant differences in resting sphincter resting pressure and resting phrenic foot tension between PPI group and PPI group. The maximal phrenic foot tension did not change significantly after 2 weeks or 4 weeks of treatment. Conclusion: biofeedback training can improve resting phrenic foot tension in patients with GERD, improve the positive symptoms of patients with GERD, and then improve the curative effect of GERD patients. It is expected that PPI can be substituted for PPI in the later stage of treatment.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571

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