伊托必利联合艾司奥美拉唑镁治疗食管运动功能障碍致胃食管反流病的临床观察

发布时间：2018-11-07 09:49

【摘要】：目的:探讨伊托必利联合艾司奥美拉唑镁治疗食管运动功能障碍致胃食管反流病(GERD)的临床疗效。方法:选取我院2015年9月-2016年9月就诊的食管运动功能障碍致GERD患者100例作为研究对象,按照随机数字表法分为对照组和观察组,各50例。对照组患者给予艾司奥美拉唑镁肠溶片40 mg,po,qd;观察组患者在对照组基础上给予盐酸伊托必利片50 mg,po,tid。两组患者均连续治疗6周。观察两组患者临床疗效及治疗前后的症状积分、食管下括约肌(LES)静息压、液体/固体吞咽情况和食管体部蠕动压力,并记录不良反应发生情况。结果:观察组患者的总有效率达94.0%,显著高于对照组的78.0%,差异有统计学意义(P0.05)。治疗前,两组患者症状积分、LES静息压、液体/固体吞咽情况和食管体部蠕动压力比较,差异均无统计学意义(P0.05)。治疗后,两组患者症状积分显著降低,且观察组显著低于对照组,差异均有统计学意义(P0.05);观察组患者LES静息压较治疗前显著升高,且显著高于对照组,差异均有统计学意义(P0.05);两组患者液体吞咽成功率均显著增加,且观察组显著高于对照组,差异均有统计学意义(P0.05);对照组患者固体吞咽成功率和液体/固体食管体部(近段、中段和远段)蠕动压力虽高于治疗前,但差异均无统计学意义(P0.05);观察组患者固体吞咽成功率和液体/固体食管体部(近段、中段和远段)蠕动压力均显著高于治疗前,且显著高于对照组同期水平,差异均有统计学意义(P0.05)。两组患者治疗过程中均未见明显的不良反应发生。结论:伊托必利联合艾司奥美拉唑镁治疗食管运动功能障碍致GERD患者,能够显著改善其临床症状,有效提高食管LES静息压,增强食管体部运动功能,提高食管吞咽成功率,增强抗反流能力,且安全性较高。
[Abstract]:Objective: to investigate the clinical effect of itopride combined with omeprazole magnesium in the treatment of gastroesophageal reflux disease (GERD) caused by esophageal motility disorder. Methods: 100 patients with GERD caused by esophageal motor dysfunction from September 2015 to September 2016 in our hospital were selected and divided into control group (n = 50) and observation group (n = 50). Control group patients were given esomeprazole magnesium enteric-coated tablets 40 mg,po,qd; observation group patients on the basis of the control group on the basis of itopride hydrochloride tablets 50 mg,po,tid. The patients in both groups were treated continuously for 6 weeks. The clinical efficacy, symptom score, (LES) resting pressure of lower esophageal sphincter, liquid / solid swallowing and peristaltic pressure of esophageal body were observed in the two groups, and adverse reactions were recorded. Results: the total effective rate of the patients in the observation group was 94.0, which was significantly higher than that in the control group (78.0), the difference was statistically significant (P0.05). Before treatment, there was no significant difference in symptom score, LES resting pressure, liquid / solid swallowing and esophageal peristalsis pressure between the two groups (P0.05). After treatment, the symptom score of the two groups decreased significantly, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). The LES resting pressure in the observation group was significantly higher than that in the control group (P0.05). The success rate of fluid swallowing in the two groups was significantly increased, and the observation group was significantly higher than the control group, the difference was statistically significant (P0.05). The success rate of solid swallowing and the peristaltic pressure of liquid / solid esophageal body (proximal, middle and distal) in the control group were higher than those before treatment, but there was no significant difference (P0.05). The success rate of solid swallowing and the peristaltic pressure of liquid / solid esophageal body (proximal, middle and distal) in the observation group were significantly higher than those before treatment and significantly higher than those in the control group (P0.05). There were no obvious adverse reactions in both groups. Conclusion: itopride combined with esoprazole magnesium in the treatment of patients with GERD caused by esophageal motor dysfunction can significantly improve the clinical symptoms, improve the resting pressure of esophageal LES, enhance the motor function of esophagus body, and improve the success rate of esophageal swallowing. Enhance anti-reflux ability and high safety.
【作者单位】：四川省医学科学院/四川省人民医院消化内科;
【分类号】：R571

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