埃索美拉唑联合氟哌噻吨美利曲辛片治疗难治性胃食管反流病的临床研究  

Combined esomeprazole with flupentixol and melitracen for refractory gastroesophageal reflux disease

作　　者：李爽[1] 李书[1] 刘倩[1] 许多[1] 刘成海[1] LI Shuang;LI Shu;LIU Qian;XU Duo;LIU Cheng-hai(Department of Gastroenterology,Baoshan Branch Hospital,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 291911;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200120)

机构地区：[1]上海中医药大学附属曙光医院宝山分院消化内科

出　　处：《中南药学》2019年第6期952-955,共4页Central South Pharmacy

基　　金：宝山区医学特色专科和社区项目建设计划资助(No.BSZK-2018-A03)

摘　　要：目的探讨埃索美拉唑联合氟哌噻吨美利曲辛片治疗难治性胃食管反流病(rGERD)的临床效果。方法选择2017年1月至2017年12月本院接诊的120例r GERD患者作为研究对象,随机将其分为观察组和对照组,各60例。所有患者均经泮托拉唑等治疗无效后接受更换药物治疗,观察组给予常规剂量埃索美拉唑联合氟哌噻吨美利曲辛片进行治疗,对照组给予大剂量埃索美拉唑进行治疗。对比两组临床疗效、症状评分、汉密尔顿焦虑量表(HAMA)评分、黏膜愈合情况及不良反应。结果经治疗,观察组治疗总有效率及黏膜总愈合率高于对照组(P <0.05);观察组嗳气、烧心、反酸及胸骨后疼痛评分均低于对照组(P <0.05);观察组患者HAMA评分低于对照组(P <0.05);观察组不良反应总发生率低于对照组(P <0.05)。结论与大剂量埃索美拉唑相比,常规剂量埃索美拉唑联合氟哌噻吨美利曲辛片治疗rGERD,可更加明显地改善临床症状,促进黏膜愈合,效果更加显著,值得推广应用。Objective To determine the clinical effect of esomeprazole with flupentixol and melitracen for refractory gastroesophageal reflux disease (rGERD). Methods Totally 120 rGERD patients who received therapy from Jan. 2017 to Dec. 2017 in our hospital were randomly divided into an observation group and a control group, 60 in each. All the patients were treated with replacement therapy after the pantoprazole treatment proved invalid. The observation group was treated with conventional dose esomeprazole with flupentixol and melitracen while the control group with high dose esomeprazole. The clinical efficacy, symptom score, Hamilton Anxiety Scale (HAMA) score, mucosal healing and adverse reactions were compared between the two groups. Results After the treatment, the total effective rate and the healing rate of mucous membrane in the observation group were higher than those of the control group (P < 0.05). Scores of belching, heartburn, acid reflux and post-sternum pain in the observation group were lower than those in the control group (P < 0.05). The HAMA score in the observation group was lower than those in the control group (P < 0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion As compared with high dose esomeprazole, conventional dose esomeprazole with flupentixol and melitracen in the treatment of rGERD, can more significantly improve the clinical symptoms, and promote mucosal healing with better effect.

关 键 词：埃索美拉唑 大剂量 氟哌噻吨美利曲辛片 难治性胃食管反流病 

分 类 号：R571[医药卫生—消化系统]