目的 探讨和分析反流性食管炎与幽门螺杆菌感染之间的关系。 方法 回顾性分析2009年1月-2011年11月间胃镜确诊为反流性食管炎334例,所有患者均行快速尿素酶试验;其中反流性食管炎合并消化性渍疡57例,慢性非萎缩性胃炎102例。 结果 反流性食管炎的幽门螺杆菌感染率为21.6% ,在幽门螺杆菌感染阳性的患者中最多见并发消化性溃疡,而在幽门螺杆菌感染阴性的患者中最多见并发慢性非萎缩性胃炎,解剖结构和动力障碍性疾病绝大多数并发于幽门螺杆菌阴性患者。A和B级反流性食管炎的幽门螺杆菌感染阴性的患者多于幽门螺杆菌感染阳性的患者。在A级反流性食管炎中幽门螺杆菌感染率28.0%,B级为8.4%,C+D级为0.0%。 结论 反流性食管炎中幽门螺杆菌感染率低,幽门螺杆菌阳性的反流性食管炎多并发于消化性溃疡,提示幽门螺旋杆菌对反流性食管炎发病有一定保护作用。
目的 观察生姜泻心汤治疗反流性食管炎的临床疗效。 方法 2006年2月-2008年3月,回顾性分析20例反流性食管炎患者,服用生姜泻心汤7 d后,停药观察1个月,应用反流性疾病问卷及胃镜检查,判断治疗效果。 结果 治愈率为35%,有效率为90%。 结论 生姜泻心汤对反流性食管炎有较好的临床疗效。
目的 研究质子泵抑制剂在反流性食管炎维持治疗的临床疗效。 方法 将2009年3月-月门诊及住院的121例反流性食管炎并胃镜证实病灶已愈合,且停药1周内症状又复发者,随机分为A、B、C 3组,3组均选用兰索拉唑。A组为兰索拉唑15 mg,1次/d,早餐前服;B组为兰索拉唑15 mg,1次/d,晚餐前服;C组兰索拉唑15 mg,2次/d,餐前服。3组疗程均为4周。疗程结束后进行临床症状疗效评定,并予复查胃镜,评价3组胃镜下总有效率,并观察3组不良反应。 结果 三种方案有效率分别为77.5%、95.0%、92.7%。 结论 晚餐前15 mg 1次/d的兰索拉唑为反流性食管炎较佳维持治疗方案。
ObjectivesTo systematically review the efficacy and safety of hydrotalcite in the treatment of reflux esophagitis (RE).MethodsCBM, CNKI, WanFang Data, VIP, PubMed, EMbase, The Cochrane Library, Web of Science and Scopus databases were searched online to collect randomized clinical trials (RCTs) of hydrotalcite or hydrotalcite plus PPI versus PPI alone in the treatment of RE from inception to June 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 1 655 patients were included. The results of meta-analysis showed that: after 4-8 weeks of treatment, there was no significant difference between hydrotalcite vs. PPI regarding RE healing rates (RR=0.87, 95%CI 0.76 to 1.00, P=0.05). However, there were significant increases in RE healing rate (RR=1.22, 95%CI 1.14 to 1.31, P<0.001) and symptom relief rate (RR=1.36, 95%CI 1.12 to 1.66,P<0.01) between hydrotalcite plus PPIvs. PPI alone. Similar increases of RE healing rate (RR=1.16, 95%CI 1.08 to 1.25, P<0.001) and symptom relief rate (RR=1.12, 95%CI 1.04 to 1.20,P<0.01) were seen in patients with refractory RE. No increase of adverse effect rate was shown with hydrotalcite or hydrotalcite plus PPI compared to PPI alone.ConclusionsCompared with PPI alone, hydrotalcite plus PPI confers a statistically significant improvement of healing rate and symptom relief rate, while it does not increase adverse effect rate. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.