体表胃肠起搏联合泮托拉唑治疗胃食管反流病疗效及胃肠激素的研究
发布时间：2018-11-08 20:29
【摘要】：目的： 观察体表胃肠起搏联合泮托拉唑治疗轻中度胃食管反流病患者的临床疗效及其对胃肠激素的影响。 方法： 以符合纳入标准及排除标准的轻中度胃食管反流病患者63例随机分成A、B两组。A组31例予以泮托拉唑肠溶胶囊（40mg/Bid，2周）及多潘立酮片（10mg/Tid，2周）治疗；B组32例患者予以泮托拉唑肠溶胶囊（40mg/Bid，2周）及体表胃肠起搏（30min/Bid，2周）治疗。对所有患者治疗前及治疗2周后进行症状积分、治疗有效率、胃电图、食管测压、胃肠激素及不良反应测定，对治疗2周后症状完全缓解的患者进行随访记录原症状首次复发时间，利用SPSS计算机统计分析治疗前后上述观察指标改变情况。 结果： 1．A、B两组患者治疗前症状积分无明显差异（P＞0.05）；治疗1周后B组有效率较A组高（P 0.05）；治疗2周后2组患者有效率无明显差异（P0.05）。 2．A、B两组患者治疗前LESP无明显差异（P0.05），治疗后两组患者LESP均较治疗前有升高（P 0.05），且B组较A组升高明显（P 0.05）。 3．A、B两组患者治疗前胃电节律及餐后/餐前功率比均无明显差异（P0.05），治疗后B组患者较A组改善明显（P 0.05）； 4．A、B两组患者治疗前胃动素、胃泌素、胆囊收缩素均无明显差异（P0.05），治疗后B组患者较A组胃动素及胃泌素含量均有升高（P 0.05），胆囊收缩素含量治疗前、后无明显差异（P0.05）。 5．在不良反应方面，应用体表胃肠起搏的B组患者中出现腹部皮肤局部灼伤1例（3.13%），排气过多至不适者3例（9.38%）。服用多潘立酮的A组患者中出现腹泻者2例（6.45%），排气过多至不适者3例（9.68%）。 6．在首次复发时间方面，B组患者较A组患者明显延长（P 0.05）。 结论： 1．体表胃肠起搏联合泮托拉唑治疗方案能有效改善轻中度胃食管反流病患者的胃电节律、餐后/餐前功率比，增加食管下段括约肌压力，并能提高血清胃动素、胃泌素浓度，促进胃动力，减少反流的发生。 2．与多潘立酮联合泮托拉唑治疗方案相比，具有起效快，不良反应小，，不易复发等特点，对轻中度胃食管反流病患者的治疗有积极意义。
[Abstract]:Objective: to observe the clinical effect of superficial gastrointestinal pacing combined with pam Tora in the treatment of mild and moderate gastroesophageal reflux disease (GERD) and its effect on gastrointestinal hormones. Methods: Sixty-three patients with mild and moderate gastroesophageal reflux disease were randomly divided into two groups: group A (n = 31) received pam Tora enteric capsule (40 mg / Bidn 2 weeks) and domperidone tablet (10 mg / Tid). 2 weeks) treatment; In group B, 32 patients were treated with pamTora enteric capsule (40 mg / Bidn 2 weeks) and body surface gastrointestinal pacing (30 min / Bidder 2 weeks). Symptom score, effective rate, electrogastrogram, esophageal manometry, gastrointestinal hormones and adverse reactions were measured before and 2 weeks after treatment. After 2 weeks of treatment, the patients with complete remission of symptoms were followed up to record the first recurrence time of the original symptoms, and the changes of the above observed indexes were analyzed by SPSS computer statistical analysis before and after treatment. Results: 1. There was no significant difference in symptom score between two groups before treatment (P > 0.05), and the effective rate of group B was higher than that of group A one week after treatment (P 0.05). After 2 weeks of treatment, there was no significant difference in the effective rate between the two groups (P0.05). 2. There was no significant difference in LESP between group A and group B before treatment (P0.05). After treatment, the LESP of group B was higher than that of group A (P 0.05), and that of group B was significantly higher than that of group A. 3. There was no significant difference in gastric electric rhythm and postprandial / preprandial power ratio between group A and group B (P0.05), but there was significant improvement in group B compared with group A (P 0.05). 4. There was no significant difference in motilin, gastrin and cholecystokinin between two groups before treatment (P0.05). After treatment, the contents of motilin and gastrin in group B were higher than those in group A (P 0.05). There was no significant difference in cholecystokinin content before and after treatment (P0.05). 5. In group B, there were 1 case (3.13%) with abdominal skin burn and 3 cases (9.38%) with excessive exhaust and discomfort. In group A, diarrhea occurred in 2 cases (6.45%), and excessive exhaust in 3 cases (9.68%). 6. The time of first recurrence in group B was significantly longer than that in group A (P 0.05). Conclusion: 1. The combination of superficial gastrointestinal pacing and pam Tora therapy can effectively improve the gastric electric rhythm, postprandial / preprandial power ratio, increase the lower esophageal sphincter pressure and increase serum motilin in patients with mild and moderate gastroesophageal reflux disease. Gastrin concentration promotes gastric motility and reduces reflux. 2.Compared with the combination of domperidone and pam Tora, it has the characteristics of quick onset, less adverse reactions and less recurrence. It has positive significance for the treatment of patients with mild to moderate gastroesophageal reflux disease (GERD).
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571
[Abstract]:Objective: to observe the clinical effect of superficial gastrointestinal pacing combined with pam Tora in the treatment of mild and moderate gastroesophageal reflux disease (GERD) and its effect on gastrointestinal hormones. Methods: Sixty-three patients with mild and moderate gastroesophageal reflux disease were randomly divided into two groups: group A (n = 31) received pam Tora enteric capsule (40 mg / Bidn 2 weeks) and domperidone tablet (10 mg / Tid). 2 weeks) treatment; In group B, 32 patients were treated with pamTora enteric capsule (40 mg / Bidn 2 weeks) and body surface gastrointestinal pacing (30 min / Bidder 2 weeks). Symptom score, effective rate, electrogastrogram, esophageal manometry, gastrointestinal hormones and adverse reactions were measured before and 2 weeks after treatment. After 2 weeks of treatment, the patients with complete remission of symptoms were followed up to record the first recurrence time of the original symptoms, and the changes of the above observed indexes were analyzed by SPSS computer statistical analysis before and after treatment. Results: 1. There was no significant difference in symptom score between two groups before treatment (P > 0.05), and the effective rate of group B was higher than that of group A one week after treatment (P 0.05). After 2 weeks of treatment, there was no significant difference in the effective rate between the two groups (P0.05). 2. There was no significant difference in LESP between group A and group B before treatment (P0.05). After treatment, the LESP of group B was higher than that of group A (P 0.05), and that of group B was significantly higher than that of group A. 3. There was no significant difference in gastric electric rhythm and postprandial / preprandial power ratio between group A and group B (P0.05), but there was significant improvement in group B compared with group A (P 0.05). 4. There was no significant difference in motilin, gastrin and cholecystokinin between two groups before treatment (P0.05). After treatment, the contents of motilin and gastrin in group B were higher than those in group A (P 0.05). There was no significant difference in cholecystokinin content before and after treatment (P0.05). 5. In group B, there were 1 case (3.13%) with abdominal skin burn and 3 cases (9.38%) with excessive exhaust and discomfort. In group A, diarrhea occurred in 2 cases (6.45%), and excessive exhaust in 3 cases (9.68%). 6. The time of first recurrence in group B was significantly longer than that in group A (P 0.05). Conclusion: 1. The combination of superficial gastrointestinal pacing and pam Tora therapy can effectively improve the gastric electric rhythm, postprandial / preprandial power ratio, increase the lower esophageal sphincter pressure and increase serum motilin in patients with mild and moderate gastroesophageal reflux disease. Gastrin concentration promotes gastric motility and reduces reflux. 2.Compared with the combination of domperidone and pam Tora, it has the characteristics of quick onset, less adverse reactions and less recurrence. It has positive significance for the treatment of patients with mild to moderate gastroesophageal reflux disease (GERD).
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571
【参考文献】
相关期刊论文 前10条
1 沈许德;王雯;;中国胃食管反流病流行病学研究状况[J];福建医药杂志;2010年03期
2 邵忠福;;消化性溃疡与胃黏膜保护剂[J];河北医药;2006年11期
3 ;二种驱动电流对动物胃起步点电位的起搏效应[J];基础医学与临床;2001年S1期
4 房殿春;胃肠起搏治疗胃肠动力紊乱性疾病[J];解放军医学杂志;2004年10期
5 高盈竹;肖国辉;;功能性消化不良与胃肠Cajal间质细胞关系的研究进展[J];西南军医;2011年05期
6 季锐;李延青;;功能性胃肠病的症状诊断[J];临床消化病杂志;2009年06期
7 张旭;徐华;;Cajal间质细胞与慢传输型便秘之间关系研究进展[J];临床消化病杂志;2011年03期
8 曾鹏;孙一耕;艾洪滨;;鲫鱼、蟾蜍、鳖、家鸽离体小肠段生理特性的比较[J];山东师范大学学报(自然科学版);2007年01期
9 林三仁;许国铭;胡品津;周丽雅;陈e
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