伏诺拉生与艾司奥美拉唑治疗重度反流性食管炎的临床疗效

doi:10.3877/cma.j.issn.2095-8765.2024.01.002

目的

对比伏诺拉生与艾司奥美拉唑治疗重度反流性食管炎的临床疗效。

方法

选择2020年12月至2021年12月在新疆维吾尔自治区人民医院消化科明确诊断为重度反流性食管炎120例患者的临床资料，随机分为2组，每组60例，分别采用伏诺拉生、艾司奥美拉唑治疗，并在治疗4及8周行胃食管反流病量表(GERD-Q)评分评价临床症状及有效率，治疗8周后复查胃镜，评估黏膜愈合情况。

结果

伏诺拉生组4、8周临床症状改善的总有效率分别为66.67%、90.00%，艾司奥美拉唑组分别为63.33%，86.67%，2组差异无统计学意义(P>0.05)；治疗8周后，伏诺拉生组、艾司奥美拉唑组内镜下黏膜愈合总有效率分别为90.00%、88.33%，差异无统计学意义(P>0.05)。

结论

伏诺拉生、艾司奥美拉唑均可以有效改善重度反流性食管炎临床症状和促进黏膜愈合。

关键词: 重度反流性食管炎, 伏诺拉生, 艾司奥美拉唑, 症状, 内镜

Objective

To compare the clinical efficacy of vonoprazol and esomeprazole in the treatment of severe reflux esophagitis.

Methods

120 patients who were diagnosed severe reflux esophagitis in the gastroenterology department of the People's Hospital of Xinjiang Uygur Autonomous Region from December 2020 to December 2021.Randomly divided into 2 groups, 60 cases in each group, were treated with vonoprazol and esomeprazole respectively, the gastroesophageal reflux disease scale (GERD-Q) score used to evaluate clinical symptoms and effective rate after 4 weeks and 8 weeks of treatment,gastroscopy was re-examined to evaluate mucosal healing after 8 weeks treatment.

Results

The total effective rates of 4-week and 8-week clinical symptom improvement in vonoprazol group were 66.67% and 90.00%, respectively; the 4-week and 8-week clinical symptom improvement rates of esomeprazole group were 63.33%, respectively. 86.67%, and there was no significant difference in the improvement of clinical symptoms between the two groups after treatment (P>0.05). After 8 weeks of treatment, the total effective rates of endoscopic mucosal healing in the vonoprazol group and the esomeprazole group were 90.00% and 88.33%, respectively, and there was no significant difference between the two groups (P>0.05).

Conclusion

Both vonoprazol and esomeprazole can effectively improve the clinical symptoms of severe reflux esophagitis and promote mucosal healing.

Key words: Severe reflux esophagitis, Vonoprazol, Esomeprazole, Symptoms, Endoscopy

表1 胃食管反流病问卷量表计分标准（分）

1周内症状发生的频率	0 d	1 d	2~3 d	4~7 d
烧心	0	1	2	3
反流	0	1	2	3
上腹部中央疼痛	3	2	1	0
恶心症状	3	2	1	0
因烧心或反流影响睡眠	0	1	2	3
额外自行服用药物来缓解烧心和（或）反流	0	1	2	3

表1 胃食管反流病问卷量表计分标准（分）

1周内症状发生的频率	0 d	1 d	2~3 d	4~7 d
烧心	0	1	2	3
反流	0	1	2	3
上腹部中央疼痛	3	2	1	0
恶心症状	3	2	1	0
因烧心或反流影响睡眠	0	1	2	3
额外自行服用药物来缓解烧心和（或）反流	0	1	2	3

表2 2组患者用药前基本情况比较

组别	例数	年龄（岁，）	性别（例）		LA分级（例）		食管裂孔疝（例）
组别	例数	年龄（岁，）	男性	女性	LA-C级	LA-D级	食管裂孔疝（例）
伏诺拉生组	60	55.41 ±13.52	38	22	42	18	27
艾司奥美拉唑组	60	56.23 ±14.73	44	16	45	15	26

表2 2组患者用药前基本情况比较

组别	例数	年龄（岁，）	性别（例）		LA分级（例）		食管裂孔疝（例）
组别	例数	年龄（岁，）	男性	女性	LA-C级	LA-D级	食管裂孔疝（例）
伏诺拉生组	60	55.41 ±13.52	38	22	42	18	27
艾司奥美拉唑组	60	56.23 ±14.73	44	16	45	15	26

表3 2组治疗 4、8 周后临床症状改善情况比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
伏诺拉生组	60
4周		29	11	20	66.67
8周		41	13	6	90.00
艾司奥美拉唑组	60
4周		27	11	22	63.33
8周		38	14	8	86.67

表3 2组治疗 4、8 周后临床症状改善情况比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
伏诺拉生组	60
4周		29	11	20	66.67
8周		41	13	6	90.00
艾司奥美拉唑组	60
4周		27	11	22	63.33
8周		38	14	8	86.67

表4 2组治疗8 周后内镜下黏膜愈合情况比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
伏诺拉生组	60	42	12	6	90.00
艾司奥美拉唑组	60	41	12	7	88.33

表4 2组治疗8 周后内镜下黏膜愈合情况比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
伏诺拉生组	60	42	12	6	90.00
艾司奥美拉唑组	60	41	12	7	88.33

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Clinical observation of Vonoprazan versus esomeprazole in the treatment of severe reflux esophagitis

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Clinical observation of Vonoprazan versus esomeprazole in the treatment of severe reflux esophagitis