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目的探讨不同方法治疗难治性胃食管反流病的临床疗效和安全性。方法 120例难治性胃食管反流病患者,随机分为A组和B组,每组60例。A组患者接受埃索美拉唑+莫沙必利治疗,B组患者接受埃索美拉唑+莫沙必利+铝碳酸镁治疗,均持续治疗8周。对比分析两组患者的临床症状改善情况、临床疗效及不良反应发生情况。结果治疗8周后,两组患者烧心、反酸、胸骨后疼痛、嗳气的临床症状评分均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05或<0.01)。B组患者显效26例,有效27例,无效7例,总有效率为88.33%,A组显效14例,有效28例,无效18例,总有效率为70.00%;两组总有效率比较差异有统计学意义(P<0.05)。A组嗜睡、口干、头晕和乏力的发生例数分别为2、3、4、2例,不良反应发生率为18.3%;B组嗜睡、口干、头晕和乏力的发生例数分别为2、1、3、2例,不良反应发生率为13.3%;两组不良反应发生率比较差异无统计学意义(χ~2=0.56,P>0.05)。结论埃索美拉唑联合莫沙必利和铝碳酸镁治疗难治性胃食管反流病的疗效显著,能够明显改善患者的临床症状,且安全性较高,在临床治疗难治性胃食管反流病时可考虑应用。
Objective To investigate the clinical efficacy and safety of different methods in the treatment of refractory gastroesophageal reflux disease. Methods A total of 120 patients with refractory gastroesophageal reflux disease were randomly divided into group A and group B with 60 cases in each group. Patients in group A received esomeprazole plus mosapride and patients in group B received esomeprazole plus mosapride plus magnesium aluminum carbonate for 8 weeks. Comparative analysis of two groups of patients to improve the clinical symptoms, clinical efficacy and adverse reactions. Results After 8 weeks of treatment, the scores of clinical symptoms of heartburn, acid reflux, post-sternum pain, and belching were lower in both groups before treatment than those in group B, and the difference was statistically significant (P <0.05 or <0.01) . In group B, 26 cases were markedly effective, 27 cases were effective, 7 cases were ineffective, the total effective rate was 88.33%, 14 cases were effective in group A, 28 cases were effective, 18 cases were ineffective and the total effective rate was 70.00%. There was statistical significance (P <0.05). The incidences of lethargy, dry mouth, dizziness and fatigue in group A were 2, 3 and 4, respectively, and the incidence of adverse reactions was 18.3%. The number of lethargy, dry mouth, dizziness and fatigue in group B were 2 , 1,3,2 cases, the incidence of adverse reactions was 13.3%; The incidence of adverse reactions was no significant difference between the two groups (χ ~ 2 = 0.56, P> 0.05). Conclusions The efficacy of esomeprazole combined with mosapride and magnesium aluminum carbonate in the treatment of refractory gastroesophageal reflux disease is significant, which can significantly improve the clinical symptoms and safety of patients. In the clinical treatment of refractory gastroesophageal reflux Flow can be considered when applied.