埃索美拉唑与雷贝拉唑治疗胃食管反流病的临床疗效比较  

The comparison of therapeutic efficacy between esomeprazol and rabeprazol in the treatment of gastroesophageal reflux disease

作　　者：周祥荣[1] 

机构地区：[1]四川省简阳市人民医院消化内科,四川简阳641400

出　　处：《实用医院临床杂志》2016年第4期93-95,共3页Practical Journal of Clinical Medicine

摘　　要：目的对比埃索美拉唑与雷贝拉唑缓解胃食管反流病(gastroesophageal reflux disease,GERD)症状和促进镜下食管黏膜愈合的疗效。方法我院确诊的GERD患者217例,按奇偶数原则分为埃索美拉唑组(A组)109例和雷贝拉唑组(B组)108例,分别给予口服埃索美拉唑40 mg qd和雷贝拉唑20 mg qd,按照胃食管反流量表和胃镜检查评估症状缓解和内镜下黏膜愈合情况,并记录睡前加用法莫替丁情况。结果经过8周标准治疗后,两组有效率和总有效率差异无统计学意义(P>0.05),显效率、无效率和睡前加用法莫替丁率差异有统计学意义(P<0.05),内镜下反流性食管炎(RE)黏膜愈合的治愈率、有效率和无效率差异有统计学意义(P<0.05)。结论埃索美拉唑与雷贝拉唑均可有效地治疗GERD,缓解GERD症状,促进RE食管黏膜愈合,但埃索美拉唑促进黏膜愈合情况优于雷贝拉唑,雷贝拉唑治疗夜间酸突破(NAB)优于埃索美拉唑,应根据GERD的不同症状和表现选取第二代PPI制剂。Objective To compare the therapeutic efficacy in improving symptoms and esophageal mucosal healing between esomeprazol and rabeprazol in the treatment of patients with gastroesophageal reflux disease （ GERD） .Methods According to the odd and even number principle,patients with GERD were randomly assigned into esomeprazol group （group A,esomeprazol 40 mg qd） and rabeprazol group （group B,rabeprazol 20 mg qd）.We assessed the symptoms relief and esophageal mucosal healing by gastroesophageal reflex questionnaire and endoscopic examination .At the same time ,we record whether the patient adds famotidine before bed .Results After 8 weeks standard treatment ,there was no significant difference between the two groups in both efficiency and total efficiency of treatment （ P 〉0.05 ） .However , there were difference in efficiency rate and inefficiency rate if adding famotidine at bedtime （ P 〈0.05 ） .The effective rate of esomeprazol was higher than rabeprazol .Moreover ,the mucosal healing cure rate and overall efficiency rate in the esomeprazol group were significantly higher than that in the rabeprazol group （P〈0.05）.Conclusion Esomeprazol and rabe-prazol can be used in the GERD treatment to alleviate the symptom of the disease and promote esophageal mucosal healing .However , esomeprazol is superior to rabeprazol in promoting mucosal healing while rabeprazol is better than esomeprazol in the treatment of NAB . Therefore,doctors should select the second generation PPI preparations based on different symptoms and signs .

关 键 词：埃索美拉唑雷贝拉唑 胃食管反流病 夜间酸突破 

分 类 号：R573.34[医药卫生—消化系统] R571[医药卫生—内科学]