不同PPIs联合莫沙必利、铝碳酸镁治疗GERD合并食管裂孔疝的临床疗效观察  

Different proton pump inhibitors combined with mosabil and aluminum magnesium carbonate in the treatment of gastroesophageal reflux disease with hiatal hernia

作　　者：李美荣 王晓伟 牛美娜 王海翠 朱双双 LI Mei-rong;WANG Xiao-wei;NIU Mei-na;WANG Hai-cui;ZHU Shuang-shuang(Department of Internal Medicine,Fourth People′s Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,China)

机构地区：[1]廊坊市第四人民医院/承德医学院附属医院内科,河北廊坊065700

出　　处：《实用药物与临床》2021年第6期505-509,共5页Practical Pharmacy and Clinical Remedies

基　　金：廊坊市科技局资助项目(2019013117)。

摘　　要：目的对比观察两种质子泵抑制剂(PPIs)联合莫沙必利、铝碳酸镁治疗胃食管反流病(GERD)合并食管裂孔疝(HH)的临床疗效及安全性。方法120例GERD合并HH患者随机分为研究组和对照组,各60例。对照组接受兰索拉唑联合莫沙必利、铝碳酸镁治疗;研究组接受埃索美拉唑联合莫沙必利、铝碳酸镁治疗。对比两组患者黏膜分级、症状积分、治疗总有效率、酸反流、胃蛋白酶原Ⅰ(PGⅠ)、胃动素(MOT)、胃泌素(GAS)、血管活性肠肽(VIP)、一氧化氮(NO)及不良反应。结果治疗后,两组患者内镜黏膜分级均有改善,且研究组优于对照组(P<0.05)。治疗后,两组患者反酸、烧心、胸痛等评分下降(P<0.05),且研究组低于对照组(P<0.05)。研究组的治疗总有效率明显高于对照组(91.67%vs.71.67%,P<0.05)。治疗后,两组患者酸暴露时间缩短(P<0.05),酸反流次数减少(P<0.05),PGⅠ水平降低(P<0.05),且两组比较差异有统计学意义(P<0.05)。治疗后,两组MOT、GAS水平增高(P<0.05),VIP、NO水平下降(P<0.05),且两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论与兰索拉唑联合莫沙必利、铝碳酸镁相比,埃索美拉唑联合莫沙必利、铝碳酸镁治疗GERD合并HH的疗效更为显著。Objective To explore the clinical efficacy and safety of two proton pump inhibitors(PPIs)combined with mosabil and aluminum magnesium carbonate in the treatment of gastroesophageal reflux disease(GERD)with hiatal hernia(HH).Methods Totally 120 cases of GERD complicated with HH were randomly divided into study group and control group,60 cases in each group.Control group was treated with lansoprazole combined with moxabil and magnesium aluminum carbonate,and study group was treated with esomeprazole combined with moxabil and magnesium aluminum carbonate.The grade of mucosa,score of symptoms,total effective rate,acid reflux,pepsinogenⅠ(PGⅠ),motilin(MOT),gastrin(GAS),vasoactive intestinal peptide(VIP),nitric oxide(NO)and adverse reactions beteen the two groups were compared.Results After treatment,the endoscopic mucosa grading of patients was improved in both groups,and the study group was superior to control group(P<0.05);the scores of reflux,heart burn and chest pain in the two groups decreased(P<0.05),and the study group was lower than control group(P<0.05);the total effective rate of study group was higher than that of control group(91.67%vs.71.67%,P<0.05).After treatment,the acid exposure time,acid reflux and PGⅠlevels in the two groups decreased(P<0.05),and there were significant differences between the two groups(P<0.05);MOT and GAS levels in the two groups increased,while VIP and NO levels decreased(P<0.05),and there were significant differences between the two groups(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with lansoprazole combined with mosabil and aluminum magnesium carbonate,esomeprazole combined with mosabil and aluminum magnesium carbonate has a more significant effect on GERD combined with HH.

关 键 词：胃食管反流病 食管裂孔疝 埃索美拉唑 兰索拉唑 莫沙必利 铝碳酸镁 

分 类 号：R571[医药卫生—消化系统]