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胃食管反流(gastro-oesophageal reflux disease,GORD)的发病率有上升的趋势。临床主要表现为烧心、反酸、胸骨后疼痛等。GORD的处理包括初步诊断及病情严重程度的评估、尽快控制症状及选择长期治疗方案三个阶段。因为60％的GORD内镜检查阴性(endoscopy negative reflux disease,ENRD),治疗的目的及疗效的评估应以症状为主。药物治疗包括H2受体拮抗剂、质子泵抑制剂及促动力剂等。目前的治疗策略包括药物递减及递增两种方式。大多数研究显示,对于症状控制或维持治疗,质子泵抑制剂疗效较H2受体拮抗剂及促动力剂要好。对于ENRD的长期治疗,间歇给药或按症状给药也可取得较好的疗效,且可降低费用。鉴于我国该病的病情较欧美相对较轻,实际用药可根据患者病情严重程度及经济状态加以选择。
The incidence of gastro-oesophageal reflux disease (GORD) is on the rise. The main clinical manifestations of heartburn, acid reflux, sternal pain and so on. GORD’s treatment includes the initial diagnosis and assessment of the severity of the disease, as soon as possible to control symptoms and long-term treatment options for the three stages. Because 60% of GORD endoscopy negative (endoscopy negative reflux disease, ENRD), the purpose of treatment and evaluation of the effect should be based on the symptoms. Drug therapy includes H2 receptor antagonists, proton pump inhibitors and promoters and so on. Current treatment strategies include decreasing and increasing medication in two ways. Most studies show that proton pump inhibitors are more effective than H2 receptor antagonists and boosters in symptom control or maintenance therapy. For the long-term treatment of ENRD, intermittent or as the symptoms can also be administered to achieve better results, and can reduce costs. In view of the disease in our country is relatively lighter than in Europe and the United States, the actual medication can be selected according to the severity of the patient’s condition and economic status.