| 351 | 28 | 138 |
| 下载次数 | 被引频次 | 阅读次数 |
目的探讨艾司奥美拉唑、莫沙必利联合铝碳酸镁治疗胃食管反流性咽喉炎(GERL)的临床疗效。方法将112例GERL患者随机分为对照组和观察组,各56例。对照组在慢性咽喉炎治疗基础上予艾司奥美拉唑镁肠溶片(20 mg,po,bid)+枸橼酸莫沙必利分散片(5 mg,po,tid),疗程8周;观察组在对照组基础上前2周加用铝碳酸镁咀嚼片(1 g,po,tid)。比较2组治疗总有效率、反流症状指数(RSI)、反流体征评分(RFS)、食管近端pH <4时间百分率、食管远端pH <4时间百分率、Demeester评分、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、促胃液素(GAS)、胃动素(MTL)、内皮素-1(ET-1)、一氧化氮(NO)、SF-36健康量表评分及不良反应的差异。结果观察组治疗后总有效率高于对照组(96.43%vs 82.14%,P <0.05)。与治疗前比较,2组治疗后RSI、RFS、食管近端pH <4时间百分率、食管远端pH <4时间百分率、Demeester评分、血清PGⅠ、ET-1、 NO水平均下降(P <0.05),血清GAS、MTL水平及躯体评分、心理评分、总体健康评分增高(P <0.05),且观察组以上指标改善程度大于对照组(P <0.05)。2组所发生的不良反应均为轻度不良反应,发生率组间差异无统计学意义(P> 0.05)。结论艾司奥美拉唑、莫沙必利联合铝碳酸镁对GERL的治疗效果优于艾司奥美拉唑联合莫沙必利。
Abstract：AIM To investigate the clinical efficacy of esomeprazole, mosapride combined with hydrotalcite in the treatment of gastroesophageal reflux laryngitis(GERL). METHODS Totally 112 GERL patients were randomly divided into control group and observation group with 56 patients in each group. The control group was treated with esomeprazole magnesium enteric-coated tablets(20 mg, po, bid) and mosapride citrate dispersible tablets(5 mg, po, tid)for 8 weeks. The observation group was treated with hydrotalcite chewable tablets(1 g, po, tid) for 2 weeks on the basis of the control group. The differences of total effective rate, reflux symptom index(RSI), reflux finding score(RFS),proximal esophageal pH < 4 time percentage, distal esophageal pH < 4 time percentage, Demeester score, pepsinogen Ⅰ(PG Ⅰ), pepsinogen Ⅱ(PG Ⅱ), gastrin(GAS), motilin(MTL), endothelin-1(ET-1), nitric oxide(NO), the MOS item short from health survey(SF-36) and the adverse reactions were compared between 2 groups. RESULTS The total effective rate of the observation group was higher than that of the control group(96.43% vs 82.14%, P < 0.05). Compared with before treatment, the level of RSI score, RFS, proximal esophageal pH < 4 time percentage, distal esophageal pH < 4 time percentage, Demeester score and serum PG Ⅰ, ET-1, NO decreased after treatament(P < 0.05), the level of serum GAS,MTL and the score of bodily, psychological and overall healthy evaluation increased after treatament(P < 0.05), and the improvement degree of above indexes in the observation group was greater than that in the control group(P < 0.05).The adverse reactions occurred in both groups were mild, and there was no significant difference in incidence between 2 groups(P > 0.05). CONCLUSION The therapeutic effect of esomeprazole and mosapride combined with hydrotalcite on GERL is better than esomeprazole combined with mosapride.
[1]李兆申,徐晓蓉,邹多武,等.胃食管反流病食管外表现的临床研究[J].中华内科杂志,2006,45(1):13.
[2]王娜,艾合买江·库尔班江,高峰.新疆胃食管反流病患者食管外表现的发生率及危险因素的研究[J].胃肠病学和肝病学杂志,2014,23(11):1259.
[3]LIU D Y,YANG H,JIANG J,et a l.Pharmacokinetic and pharmacodynamic modeling analysis of intravenous esomeprazole in healthy volunteers[J].J Clin Pharmacol,2016,56(7):816.
[4]李科,李可亮,杨娟娟,等.咽喉反流性疾病诊断和治疗研究进展[J].中国中西医结合耳鼻咽喉科杂志,2020,28(2):157.
[5]YUCEL E,SANCAR M,YUCEL A,et al.Adverse drug reactions due to drug-drug interactions with proton pump inhibitors:assessment of systematic reviews with AMSTAR method[J].Expert Opin Drug Saf,2016,15(2):223.
[6]赵王磊,陈欣,陈凤英.质子泵抑制剂在治疗反流性食管炎中的疗效:网状Meta分析[J].胃肠病学和肝病学杂志,2017,26(6):697.
[7]陈旻湖,侯晓华,肖英莲,等.2014年中国胃食管反流病专家共识意见[J].胃肠病学,2015,20(3):155.
[8]中华耳鼻咽喉头颈外科杂志编辑委员会咽喉组,中华医学会耳鼻咽喉头颈外科学分会咽喉学组.咽喉反流性疾病诊断与治疗专家共识（2015年）[J].中华耳鼻咽喉头颈外科杂志,2016,51(5):324.
[9]朱清,裴小红,黄重发,等.SF-36量表在胃食管反流病患者生存质量评价中的应用[J].疑难病杂志,2010,9(3):188.
[10]马建刚,段乃超,贾晓菲.反流性咽喉炎的诊断与治疗[J].临床荟萃,2017,32(1):46.
[11]季梦遥,董卫国,许昱,等.反流性咽喉炎的循证治疗[J].循证医学,2014,14(4):234.
[12]郑杰元,张立红,李晶兢,等.咽喉反流症状指数量表中文版的信度及效度评价[J].中华耳鼻咽喉头颈外科杂志,2012,47(11):894.
[13]WU M S,TAN S C,XIONG T.Indirect comparison of randomised controlled trials:comparative efficacy of dexlansoprazole vs.esomeprazole in the treatment of gastro-oesophageal reflux disease[J].Aliment Pharmacol Ther,2013,38(2):190.
[14]刁凌云,王胜英,皇金萍.荜铃胃痛颗粒联合盐酸伊托必利及艾司奥美拉唑治疗反流性食管炎的疗效观察[J].现代医学,2020,48(1):88.
[15]刘锦,刘静.咽喉反流性疾病的中西医诊疗进展[J].山东中医杂志,2019,38(6):599.
[16]李进让.咽喉反流性疾病规范化诊断和治疗[J].中国耳鼻咽喉头颈外科,2015,22(9):435.
[17]汪忠镐,吴继敏,胡志伟,等.中国胃食管反流病多学科诊疗共识[J].中国医学前沿杂志(电子版),2019,11(9):30.
[18]夏挺松,李海云.雷贝拉唑联合莫沙必利治疗食管反流性咽喉炎56例临床分析[J].临床消化病杂志,2011,23(4):245.
[19]杨晓玉.奥美拉唑单用或联合法莫替丁治疗胃-食管反流病疗效比较[J].中国药业,2017,26(19):65.
[20]陈茹,林森,陈崇喜,等.咽喉反流与焦虑、抑郁症状的相关分析和治疗[J].中国耳鼻咽喉头颈外科,2015,22(9):449.
[21]JOHNSTON N,YAN J C,HOEKZEMA C R,et al.Pepsin promotes proliferation of laryngeal and pharyngeal epithelial cells[J].Laryngoscope,2012,122(6):1317.
[22]XIAO Y L,NIE Y Q,HOU X H,et al.The efficacy,safety and costeffectiveness of hydrotalcite versus esomeprazole in on-demand therapy of NERD:a multicenter,randomized,open-label study in China[J].J Dig Dis,2013,14(9):463.
[23]宾楚轩,陈婧,冯跃,等.难治性胃食管反流病患者中的胃蛋白酶原及胃泌素17水平与食管反流情况的研究[J].胃肠病学和肝病学杂志,2020,29(11):1245.
[24]毛华,丘文丹,唐银丽,等.唾液中胃蛋白酶原的浓度与胃食管反流病的相关性[J].实用医学杂志,2013,29(6):913.
[25]滕小军,刘荣,李祥金,等.内皮素1及其受体在反流性食管炎及Barrett食管中的表达及意义[J].中华临床医师杂志(电子版),2012,6(24):8118.
[26]李达周,徐桂林,王雯.一氧化氮在胃食管反流病发病机制中的作用[J].中华胃食管反流病电子杂志,2016,3(4):183.
[27]岳爱君,尹宇杰,李莹.一氧化氮合酶、环氧合酶-2在不同类型胃食管反流病中的表达及意义[J].世界华人消化杂志,2020,28(18):891.
基本信息:
DOI：10.19577/j.1007-4406.2022.01.009
中图分类号:R571;R766.5
引用信息:
[1]王海翠,牛美娜,李美荣,等.艾司奥美拉唑、莫沙必利联合铝碳酸镁治疗胃食管反流性咽喉炎的临床疗效[J].中国临床药学杂志,2022,31(01):41-46.DOI:10.19577/j.1007-4406.2022.01.009.
基金信息:
廊坊市科技局资助项目（编号2019013117）
2022-01-25
2022-01-25