伏诺拉生治疗食管胃吻合术后反流性食管炎的临床效果观察  

Observation of Clinical Effect of Vonoprazan in the Treatment of Reflux Esophagitis after Esophagogastric Anastomosis

作　　者：沈亚娟 丁建伟 SHEN Yajuan;DING Jianwei(Department of Gastroenterology,People's Hospital of Tongliang District,Chongqing 402560,China)

机构地区：[1]重庆市铜梁区人民医院消化内科,重庆402560

出　　处：《临床误诊误治》2023年第12期66-71,共6页Clinical Misdiagnosis & Mistherapy

基　　金：重庆市铜梁区2021年区级科技项目(TL2021-16)。

摘　　要：目的观察伏诺拉生治疗食管胃吻合术后反流性食管炎(RE)的临床效果。方法选取2022年1—10月收治的食管胃吻合术后RE 60例,随机将其分为研究组和对照组2组各30例。研究组给予伏诺拉生治疗,对照组给予艾司奥美拉唑治疗。比较2组治疗4周后临床效果,治疗前及治疗2、4周后生化指标、反流病症状频率量表(FSSG)评分,治疗前及治疗4周后洛杉矶标准(LA)分级,以及治疗期间不良反应、随访3个月复发情况。结果治疗4周后,研究组总有效率93.33%(28/30)高于对照组73.33%(22/30)(P<0.05)。治疗2和4周后,研究组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-23(IL-23)、降钙素基因相关肽(CGRP)、血红素氧合酶-1(HO-1)及FSSG评分低于对照组,血清谷胱甘肽(GSH)高于对照组(P<0.05)。治疗前和治疗2、4周后,2组组内血清TNF-α、IL-1β、IL-23、CGRP、HO-1及FSSG评分呈逐渐降低趋势,血清GSH呈逐渐升高趋势(P<0.05)。治疗4周后,2组组内LA分级均较治疗前改善(P<0.01)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。随访3个月,研究组复发率3.33%(1/30)低于对照组26.67%(8/30)(P<0.05)。结论伏诺拉生治疗食管胃吻合术后RE患者效果优于艾司奥美拉唑,可调控血清炎性因子及CGRP、HO-1、GSH水平,减轻胃肠道损伤,改善临床症状,且复发率低。Objective To observe the clinical effect of Venolazine in the treatment of reflux esophagitis(RE)after esophagogastric anastomosis.Methods A total of 60 patients with RE after esophagogastric anastomosis treated in our hospital from January to October 2022 were randomly divided into the research group and the control group,with 30 cases in each group.The research group was treated with Venolazine and the control group was treated with Esomeprazole.The clinical effect at 4 weeks after treatment,biochemical indexes,frequency scale for the symptoms of gastroesophageal reflux disease(FSSG)scores before treatment and at 2 and 4 weeks after treatment,Los Angeles(LA)grading before treatment and at 4 weeks after treatment,adverse reactions during treatment and recurrence at 3 months after follow-up were compared between the two groups.Results At 4 weeks after treatment,the total effective rate of the research group was 93.33%(28/30),which was higher than that of the control group[73.33%(22/30)](P<0.05).At 2 and 4 weeks after treatment,serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-23(IL-23),calcitonin gene-related peptide(CGRP),heme oxygenase-1(HO-1)and FSSG scores of the research group were lower than those of the control group,and serum glutathione(GSH)was higher than that of the control group(P<0.05).Before treatment and at 2 and 4 weeks after treatment,serum TNF-α,IL-1β,IL-23,CGRP,HO-1 and FSSG scores in the two groups were gradually decreased,while serum GSH was gradually increased(P<0.05).At 4 weeks after treatment,LA grading in both groups was improved compared with that before treatment(P<0.01).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).At 3 months after follow-up,the recurrence rate of the research group was 3.33%(1/30),which was lower than that of the control group[26.67%(8/30)](P<0.05).Conclusion The therapeutic effect of Venolazine on RE patients after esophagogastric anastomosis is better than Esomepr

关 键 词：伏诺拉生 艾司奥美拉唑 食管肿瘤 食管胃吻合术 食管炎 肿瘤坏死因子-α 白细胞介素-1Β 降钙素基因相关肽 

分 类 号：R735.1[医药卫生—肿瘤] R571[医药卫生—临床医学]