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目的通过观察埃索美拉唑、多潘立酮与铝碳酸镁联合治疗对胆汁反流性胃炎(BRG)临床症状及电子胃镜下胃黏膜的影响,评价其临床疗效。方法 90例BRG患者按照完全随机数字表法随机分为观察组和对照组,每组45例。对照组给予多潘立酮、铝碳酸镁治疗,观察组在上述治疗基础上联合埃索美拉唑。观察比较2组的临床症状、胃内吸出物和胃镜下黏膜情况。结果 2组患者年龄、性别、病程、临床症状等资料比较差异无统计学意义(P>0.05)。2组患者治疗前各症状评分比较差异无统计学意义(P>0.05)。治疗后,2组各症状评分均较治疗前显著改善,且观察组降低程度显著优于对照组(P<0.05)。治疗后,观察组的胃液胆酸含量、胃酸分泌量分别为(85.13±61.64)mg/ml,(1.31±0.27)mmol/h,均显著低于对照组的(136.28±92.36)mg/ml,(2.81±0.54)mmol/h(P<0.05)。治疗后胃镜下观察2组患者胃黏膜充血、水肿、糜烂、粘液湖胆染等情况均明显改善。观察组的胃黏膜充血、水肿、糜烂评分分别为(0.82±0.29)、(0.56±0.16)、(0.62±0.15)分,对照组的胃黏膜充血、水肿、糜烂评分分别为(1.38±0.32)、(1.53±0.18)、(1.36±0.19)分,2组差异均具有统计学意义(P<0.05)。结论埃索美拉唑、多潘立酮、铝碳酸镁在BRG的治疗上有协同作用,联合使用可更好地改善临床症状,保护胃黏膜。
Objective To observe the clinical effects of esomeprazole, domperidone and aluminum magnesium carbonate on the clinical symptoms of bile reflux gastritis (BRG) and gastric endoscopy by gastroscope to evaluate its clinical efficacy. Methods Ninety patients with BRG were randomly divided into observation group and control group according to a completely random number table method, with 45 cases in each group. The control group was treated with domperidone and magnesium aluminum carbonate. The observation group was given esomeprazole combined with the above treatment. The clinical symptoms, gastric aspirates and gastroscopic mucosa were compared between the two groups. Results There was no significant difference in age, sex, course of disease and clinical symptoms between the two groups (P> 0.05). There was no significant difference in symptom scores between the two groups before treatment (P> 0.05). After treatment, the score of each symptom in both groups was significantly improved compared with that before treatment, and the reduction in observation group was significantly better than that in control group (P <0.05). After treatment, the gastric acid secretion and gastric acid secretion in the observation group were (85.13 ± 61.64) mg / ml and (1.31 ± 0.27) mmol / h, respectively, which were significantly lower than those in the control group (136.28 ± 92.36) mg / (2.81 ± 0.54) mmol / h (P <0.05). After treatment, gastric mucosal hyperemia, edema, erosion and mucus lameness in both groups were significantly improved after gastroscopy. The gastric mucosal congestion, edema and erosions in the observation group were (0.82 ± 0.29), (0.56 ± 0.16) and (0.62 ± 0.15) points, respectively. The gastric mucosa congestion, edema and erosion score in the control group were (1.38 ± 0.32) , (1.53 ± 0.18) and (1.36 ± 0.19) points, respectively. The differences between the two groups were statistically significant (P <0.05). Conclusions Esomeprazole, domperidone and magnesium aluminum carbonate have synergistic effects on the treatment of BRG. Combined use can improve clinical symptoms and protect gastric mucosa.