摘要
目的探讨膈肌生物反馈训练加强GERD患者胃食管交界处（EGJ）抗反流屏障作用。方法80例GERD患者随机分为PPI组和PPI联合膈肌生物反馈训练组。每组分别人选40例，疗程为8周。PPI组（雷贝拉唑10mgBid）。反馈＋PPI组在应用PPI治疗同时进行膈肌生物反馈训练（2次／d，15-20min／次，雷贝拉唑10mgBid）。反馈＋PPI组患者每周1次到医院在医生指导下进行反馈训练，训练时需空腹。疗程结束后再次评价反流症状、食管动力和内镜下反流性食管炎改善情况。结果（1）治疗8周后，反馈＋PPI组反流症状积分由治疗前（10．5±5．3）下降至（6．0±3．7），PPI组由治疗前（10．8±4．7）下降至（7．5±3．2）；（2）反馈＋PPI组生活质量（GERD—HRQL）积分由治疗前（21．774-6．30）下降至（13．60±7．538），PPl组由治疗前（20．42±6．31）下降至（13．864±7．538）；（3）反馈＋PPI组较PPI组自主神经受累改善率提高35％；（4）反馈＋PPI组与PPI组治疗前后Zung氏焦虑和抑郁自评量表评分比较差异无统计学意义（P〉O．05）；（5）动力学复查，除膈脚张力显著增加外，LES压力、EGJ压力及食管远端蠕动收缩波幅训练前后差异均无统计学意义。结论膈肌生物反馈训练能显著改善反流症状，减少GERD患者对抑酸药物依赖性；增加GERD患者膈脚的张力，从而增强胃食管交界处的抗反流屏障作用。
Objective To investigate the functions of anti-reflux of diaphragms biofeedback training on Gastrcescphageal reflux disease （GERD）. Methods 80 cases of GERD patients were randomly divided into trail group and control group. 40 patients in trail group were trained diaphragma biofeedback 15 - 20minutes bid while they received rabeprazole 10rag bid po. 40 patients in control group received rabeprazole 10mg bid po. All the patients were assessed the effect of reflux symptom,esophageal motility and endoscopic reflux escphagitis at 8th weeks after treatment. Results Symptom scores reduced from 10.5 ± 5.3 to 6.0 ± 3.7 at 8th weeks after treatment in trail group and from 10.8 ±4.7 to7.5 ±3.2 in control group;scores of HRQL in trail group reduced from 21.77 ±6.30 to13.60 ±7.538 at 8th weeks after treatment and from20.42 ± 6.31 to13.86 ± 7.538 in control group ; autonomic nerve function improve rate in trail group was 35% higher than that in control group; Zung＇s anxiety and depression scores were no significant difference between two gToups （P ;〉 0.05 ） ; In addition to strengthen tension of erural diaphragm,there were no significant difference in LESp,LES pressure and contractive amplitude of distal esophagus before and after training. Conclusion Diaphragm biofeedback training can improve the reflux symptoms and reduce inhibitory gastric acid drug dependence constipation on GERD patients by strengthening the gastroescphagnal junction anti-reflux barrier.
出处
《内科》
2009年第2期193-197,共5页
Internal Medicine
关键词
胃食管反流病
生物反馈
膈脚
抗反流屏障
Gastreesophageal reflux disease
Biofeedback
Crural diaphragm
Anti reflux barrier
