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目的观察比较雷贝拉唑与奥美拉唑短期治疗老年人反流性食管炎的疗效。方法80例经内镜证实的反流性食管炎的老年患者,随机分为两组,分别给予口服雷贝拉唑10 mg/d与奥美拉唑20 mg/d,其中H.pylori阳性者应用质子泵抑制剂同时加用克拉霉素250 mg、阿莫西林1.0 g或甲硝唑400 mg,7 d一疗程,共治疗8个疗程。8疗程后,分别观察临床症状、不良反应,经内镜观察食管炎愈合程度,评价治疗效果。结果治疗8周后雷贝拉唑组食管炎愈合率按方案(PP)和意向治疗(ITT)分析分别为92.11%、87.50%,奥美拉唑组食管炎愈合率按PP和ITT分析分别为72.97%、67.50%,两组差异有统计学意义(P<0.05)。雷贝拉唑组烧心症状比奥美拉唑组明显改善(P<0.05)。H.Pylori阳性和阴性患者的RE愈合率比较,差异无统计学意义(P>0.05)。H.Pylori已治愈和H.Pylori仍阳性患者的RE愈合率比较,差异无统计学意义(P>0.05)。两组均无与用药相关的不良反应发生。结论雷贝拉唑和奥美拉唑相比,雷贝拉唑治疗老年人反流性食管炎愈合率高,更能有效改善症状。H.Pylori感染不影响两种质子泵抑制剂治疗反流性食管炎的愈合率。
Objective To compare the efficacy of short-term treatment of reflux esophagitis with rabeprazole and omeprazole in the elderly. Methods Eighty elderly patients with reflux esophagitis confirmed by endoscopy were randomly divided into two groups. The rabbits were given oral rabeprazole 10 mg / d and omeprazole 20 mg / d respectively, among which H.pylori positive Application proton pump inhibitor plus clarithromycin 250 mg, amoxicillin 1.0 g or metronidazole 400 mg, 7 d a course of treatment for a total of 8 courses. After 8 courses of treatment, the clinical symptoms and adverse reactions were observed. The extent of esophagitis healing was evaluated by endoscopy. Results After 8 weeks of treatment, the healing rate of esophagitis in rabeprazole group was 92.11% and 87.50% according to protocol (PP) and intention to treat (ITT) respectively. The healing rate of esophagitis in omeprazole group was 72.97% , 67.50%, the difference between the two groups was statistically significant (P <0.05). The heartburn symptoms of rabeprazole group were significantly better than those of omeprazole group (P <0.05). There was no significant difference in the healing rate of RE between H.pylori positive and negative patients (P> 0.05). There was no significant difference in the healing rate of RE between H.Pylori-cured and H. pylori-positive patients (P> 0.05). No adverse drug reactions occurred in both groups. Conclusion Rabeprazole and omeprazole, rabeprazole treatment of elderly reflux esophagitis rate of healing, more effective in improving symptoms. H. pylori infection does not affect the healing rate of two proton pump inhibitors in the treatment of reflux esophagitis.