体表胃肠起搏治疗胃食管反流病的临床疗效  

Clinical efficacy of surface gastrointestinal pacing in treating gastroesophageal reflux disease

作　　者：陈腾千 姜丽华 蒋义贵 张生君 罗佳 胡永敏 尤丽财 CHEN Tengqian;JIANG Lihua;JIANG Yigui(Department of Gastroenterology,Affiliated Sanming First Hospital,Fujian Medical University,Sanming 365000,CHINA)

机构地区：[1]福建医科大学附属三明第一医院消化内科,福建三明365000

出　　处：《江苏医药》2024年第1期63-66,共4页Jiangsu Medical Journal

基　　金：三明市科技计划项目(2019-S-5)。

摘　　要：目的 探讨体表胃肠起搏治疗胃食管反流病(GERD)的临床疗效。方法 经胃镜检查确诊为GERD的60例患者随机分为对照组及观察组,每组30例。两组均常规给予艾司奥美拉唑肠溶片、铝碳酸镁咀嚼片和依托必利片治疗,观察组增加体表胃肠起搏治疗。两组通过高分辨率食管测压监测食管下括约肌压力(LESP)及4-s完整松弛压(4sIRP)、远端潜伏期(DL)和远端收缩积分(DCI)等食管蠕动波参数,观察治疗前及治疗1周后的临床症状积分、LESP及食管蠕动波参数水平变化。结果 与治疗前比较,两组治疗1周后烧心、反酸、嗳气、上腹痛、上腹烧灼感、上腹胀和胸痛7个症状积分及总积分均降低,LESP、4sIRP、DL和DCI升高(P<0.05)。治疗1周后,观察组症状总积分及反酸、嗳气、上腹胀和胸痛4个症状积分低于对照组,LESP、4sIRP、DL和DCI高于对照组(P<0.05)。治疗1周后,观察组症状改善总有效率高于对照组(96.7%vs.80.0%)(P<0.05)。结论 GERD患者在常规治疗基础上加用体表胃肠起搏治疗可以明显改善患者的临床症状,其机制可能与增强LESP及食管蠕动有关。Objective To explore the clinical efficacy of surface gastrointestinal pacing in the treatment of gastroesophageal reflux disease(GERD).Methods Sixty GERD patients diagnosed through gastroscopy were randomly divided into control group and observation group with 30 cases each.Both groups were conventionally treated with esomeprazole enteric coated tablets, magnesium aluminate chewable tablets and etopride tablets.Observation group received additional surface gastrointestinal pacing therapy.The esophageal peristaltic wave parameters including lower esophageal sphincter pressure(LESP),4-second intact relaxation pressure(4sIRP),distal latency(DL),and distal contraction integral(DCI) were monitored by high-resolution esophageal manometry.The clinical symptom score, LESP and esophageal peristaltic wave parameters were recorded before and one week after treatment.Results Compared with before treatment, the total scores and scores of 7 symptoms, including heartburn, acid reflux, belching, upper abdominal pain, upper abdominal burning sensation, upper abdominal distension and chest pain were reduced and LESP,4sIRP,DL and DCI were increased in both groups after one week of treatment(P<0.05).After one week of treatment, the total symptom score and four symptom scores of acid reflux, belching, upper abdominal distension and chest pain were lower, while LESP,4sIRP,DL and DCI were higher in observation group than those in control group(P<0.05).After one week of treatment, the total effective rate of symptom improvement in observation group was higher than that in control group(96.7% vs.80.0%)(P<0.05).Conclusion On the basis of conventional treatment, additionally use of surface gastrointestinal pacing therapy can more effectively improve the clinical symptoms of GERD patients.The mechanism for that may be related to enhancing the pressure of LESP and esophageal peristalsis.

关 键 词：胃食管反流病 体表胃肠起搏治疗 

分 类 号：R571[医药卫生—消化系统]