PPI治疗胃食管反流病(GERD)的临床研究  

Clinical study on treating gastroesophageal reflux disease with PPI

作　　者：邹科文[1] 谢远辉[2] 叶向明 叶仁群[1] 区显维[1] 丁文[1] 

机构地区：[1]广东省深圳市宝安区中医院消化内科,广东深圳518133 [2]广东省深圳市疾病预防控制中心,广东深圳518101 [3]广东省深圳市宝安区石岩预防保健所,广东深圳518101

出　　处：《中国现代医生》2012年第8期68-69,共2页China Modern Doctor

基　　金：2011年广东省深圳市科技计划项目(医疗卫生类)(201103097)

摘　　要：目的观察质子泵抑制剂奥美拉唑、雷贝拉唑对胃食管反流病(GERD)的疗效。方法筛选具有烧心和反流症状并经内镜证实食管下段有黏膜损伤的GERD患者200例,随机分两组OAC 101例口服奥美拉唑20 mg每天2次、治疗4周;RAC 99例口服雷贝拉唑20 mg每天2次,治疗4周。每周随访1次,分别于2周和4周评价疗效。结果两组在治疗结束后,临床症状改善及内镜表现差异有高度统计学意义,P<0.01。但总体疗效并非十分理想,个体差异大。结论本研究结果提示细胞色素P4502C19(CYP2C19)是PPI在肝脏代谢的主要途径,其基因型是导致药物疗效的个体差异的直接因素,为今后研究PPI治疗GERD的疗效及与CYP2C19基因多态性的关系打下基础。Objective To observe the effects of Omeprazole and Rabeprazole on GERD. Methods All of 200 patients with GERD were randomly divided into two groups, 101 patients in omeprazole group orally received omeprazole 20 mg, 2 times a day, for 4 weeks and 99 patients in rabeprazole orally received rabeprazole 20 mg,2 times a day,for 4 weeks. Clinical efficacy was observed in patients of both groups after a treatment course of 2 weeks and 4 weeks. Results The rates of effi- cacy in patients of Rabeprazole group and Omeprazole group were 79.79% and 60.39% ,then their marked effectiveness rates in endoscopic were 84.84% and 64.35% respectively. There was significant difference between two groups （P 〈 0.01）. Thus the overall effect was not satisfied,founding marked individual differences. This results prompt Cytochrome P4502C19 （CYP2C19） is the main way of PPI metabolism in the liver, the genotype is the leading cause of drug efficacy of individual differences in the direct factors, for future studies of PPI therapy for the treatment of GERD and CYP2C19 gene polymorphism and lay the foundation.

关 键 词：雷贝拉唑 奥美拉唑 胃食管反流病 细胞色素 

分 类 号：R573[医药卫生—消化系统]