莫沙必利、泮托拉唑联合磷酸铝凝胶治疗胆汁反流性胃炎的疗效观察|磷酸铝凝胶和泮托拉唑

　　[摘要] 目的 探讨联合应用莫沙必利、泮托拉唑和磷酸铝凝胶治疗胆汁反流性胃炎（BRG）的临床疗效。 方法 将186例BRG患者随机分为A、B、C 3组，每组各62例，A组采用莫沙必利+泮托拉唑+磷酸铝凝胶治疗，B组采用莫沙必利+泮托拉唑治疗，C组采用莫沙必利+磷酸铝凝胶治疗，用药第4周及8周评价3组的临床症状改善情况，8周做内镜评价。 结果 A、B、C 3组用药后的临床症状均明显改善，治疗第4周时，A组的改善情况明显优于B组和C组，差异有统计学意义（P < 0.05）；治疗8周时，A、B、C 3组的临床症状改善总有效率分别为98.39%、87.10%和90.32%，内镜评价总有效率分别为98.39%、88.70%和91.94%，3组比较，A组显著优于B组和C组，差异有统计学意义（P < 0.05）。 结论 莫沙必利、泮托拉唑联合磷酸铝凝胶治疗BRG的临床疗效良好。
　　[关键词] 胆汁反流性胃炎；莫沙必利；泮托拉唑；磷酸铝凝胶
　　[中图分类号] R573.3 [文献标识码] A [文章编号] 1674-4721（2012）07（c）-0042-03
　　Clinical effects of the mosapride combined with pantoprazole and aluminum phosphate gel on patients with bile reflux gastritis
　　LIU Shengqi MI Ming HUANG Rongwang
　　Shilong Boai Hospital Affiliated to Guangdong Medical College, Dongguan 523320, China
　　[Abstract] Objective To evaluate the effect of the mosapride combined with pantoprazole and aluminum phosphate gel on patients with bile reflux gastritis. Methods One hundred and eighty-six patients with bile reflux gastritis were randomly divided into A, B and C group, each group of 62 cases. Group A was treated by mosapride + pantoprazole + aluminum phosphate gel; Group B was treated by mosapride + pantoprazole. Group C was treated by mosapride + aluminum phosphate gel. Treated for 4 weeks and 8 weeks later, the patients were appraised the change of the clinic symptom, 8 weeks later, they were appraised by gastroscope. Results The clinic symptom of A, B and C group was changed a lot when had be treated. When in the 4th week, the change of the clinic symptom in Group A was better than Group B and C, there were statistical differences (P < 0.05). And when in the 8th week, the total effective rate of the clinic symptom of A, B and C three groups was 98.39%, 87.10% and 90.32%，the total effective rate of the gastroscope of them was 98.39%, 88.70% and 91.94%, Group A was better than Group B and C, there were statistical differences (P < 0.05). Conclusion The clinical efficacy of mosapride combined with pantoprazole and aluminum phosphate gel in treatment of the bile reflux gastritis is favorable.
　　[Key words] Bile reflux gastritis; Mosapride; Pantoprazole; Aluminum phosphate gel
　　胆汁反流性胃炎（bile reflux gastritis，BRG）是一种临床上比较常见的特殊类型胃炎中的化学性胃炎[1]，因为反流液体呈碱性，故又称为碱性反应性胃炎（alkalinereflux gastritis，ARG）[2]，是由含有胆汁、胆盐、溶血卵磷脂、胰酶等的十二指肠内容物经幽门口反流入胃后，干扰胃黏膜屏障，促进H+胃蛋白酶反弥散入胃黏膜，进一步引起损伤，导致炎症发生所致的一种病症[3]。临床常见胃部饱胀或不适，或有胃痛，或有胃部发凉，可伴腹胀、嗳气、反酸、烧心、恶心、呕吐、食欲减退、消瘦等症状[4]。胆酸是导致胃黏膜发生炎症的关键因素之一。莫沙必利是一种全胃肠促动力剂，可调节胃肠动力，增加胃肠蠕动，促进胃排空，减轻胃食管反流；泮托拉唑是一种质子泵抑制剂，具有较强的抑酸作用，能有效地降低胃酸和胃酸的活性；磷酸铝凝胶是一种新型的制酸剂，既可中和胃酸又可在酸性环境下结合胆酸,凝胶剂的磷酸铝能形成胶体保护性薄膜,使黏膜深层免受酸的侵袭,能隔离并保护损伤组织。为使胆汁反流性胃炎得到全面的治疗，提高其疗效，本文采用三药联合使用的治疗方法治疗BRG，并取得较满意的效果，现总结分析报道如下：