摘要
目的:观察He-Ne激光照射联合质子泵抑制剂(PPIs)、胃动力药治疗反流性食管炎(RE)的疗效。方法:将126例RE患者随机分为观察组和对照组,各63例。对照组采用埃索美拉唑、伊托必利治疗;观察组在对照组基础上实施He-Ne激光照射治疗。比较两组临床疗效及治疗前后临床症状评分、内镜分级积分、食管动力学指标、胃肠激素和胃蛋白酶原水平。结果:观察组治疗总有效率(92.06%)显著高于对照组(77.78%),差异有统计学意义(P<0.05)。经治疗后,两组烧心、反酸、胸痛等临床症状评分及内镜分级积分均降低(P<0.05),但与对照组相比,观察组以上临床症状评分及内镜分级积分降低更明显(P<0.05)。治疗后,两组食管括约肌压力明显增高,立位反流时间比、卧位反流时间比、总反流时间比明显下降(P<0.05),但观察组以上指标与对照组相比改善程度更大(P<0.05)。与治疗前比较,两组治疗后GAS、MOT、PG I、PGⅠ/PGⅡ明显增高(P<0.05),VIP明显下降(P<0.05),但观察组改善幅度大于对照组(P<0.05)。结论:He-Ne激光照射联合PPIs、胃动力药治疗RE的疗效显著,优于单纯应用PPIs和胃动力药治疗,能有效改善患者的食管动力学指标及胃肠激素水平。
Objective:To observe the effects of He-Ne laser irradiation combined with proton pump inhibitors(PPIs),gastric motility drug on reflux esophagitis.Methods:126 RE patients were randomly divided into observation group and control group,with 63 cases each.The control group was treated with itopril and esomeprazole,the observation group was treated with laser irradiation on the basis of the control group.The differences of clinical efficacy,clinical symptom score,endoscopic grading score,esophageal dynamics indexes,the levels of gastrointestinal hormones and pepsinogens before and after treatment were compared between the two groups.Results:The total effective rate of the observation group(92.06%)was significantly higher than that of the control group(77.78%),and the difference was statistically significant(P<0.05).After treatment,clinical symptom scores such as heartburn,acid reflux,chest pain and endoscopic grading scores in both groups reduced(P<0.05),but compared with the control group,the clinical symptom scores and endoscopic grading scores of the observation group reduced significantly(P<0.05).After treatment,the pressure of esophageal sphincter was significantly increased in the two groups,and the vertical reflux time ratio,horizontal reflux time ratio and total reflux time ratio were significantly decreased(P<0.05),but the improvement degree of the above indicators in the observation group was greater than that in the control group(P<0.05).Compared with before treatment,GAS,MOT,PGⅠ,PGⅠ/PGⅡafter treatment significantly increased in the two groups(P<0.05),VIP decreased obviously(P<0.05),but the improvement of the above indexes in the observation group was greater than that in the control group(P<0.05).Conclusion:He-Ne laser irradiation combined with PPIs,gastric motility drug have a significant effect on RE,which is better than PPIs combined with gastric motility drug,and can effectively improve the esophageal dynamics and gastrointestinal hormone levels of the patients.
作者
朱双双
李美荣
王晓伟
牛美娜
王海翠
Zhu Shuangshuang;Li Meirong;Wang Xiaowei;Niu Meina;Wang Haicui(Department of Internal Medicine,Fourth People’s Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang,Hebei 065700,China)
出处
《应用激光》
CSCD
北大核心
2021年第6期1357-1361,共5页
Applied Laser
基金
廊坊市科学技术研究与发展计划(2019013117)。
关键词
反流性食管炎
HE-NE激光
质子泵抑制剂
胃动力药
食管动力学
胃肠激素
reflux esophagitis
He-Ne laser
proton pump inhibitors
gastric motility drug
esophageal dynamics
gastrointestinal hormone
