摘要
[目的]观察对胃食管反流病患者在质子泵抑制剂和益生菌的基础上应用曲美布汀进行治疗的临床效果以及对患者肠道菌群的影响。[方法]选取胃食管反流病患者96例,以随机数字法原则将其分为对照组(48例)和观察组(48例)。对照组患者给予奥美拉唑肠溶片40 mg于早晚饭前服用,2次/d;以及双歧杆菌三联活菌胶囊630 mg口服,2次/d。观察组患者在对照组用药的基础上加用曲美布汀片100 mg口服,3次/d。所有患者均连续治疗12周后对其疗效、治疗前后GerdQ评分、食管远端收缩积分(DCI)、高分辨率食管测压(HRM)、症状和发作频率评分以及肠道菌群变化进行评价。[结果]治疗前,观察组与对照组患者的GerdQ评分、DCI、HRM、症状发作频率评分以及肠道菌群分布比较均差异无统计学意义(P>0.05);治疗后,观察组患者的DCI、下食管括约肌静息压水平明显高于对照组,而GerdQ、上食管括约肌静息压、症状以及发作频率评分均明显低于对照组,2组之间均差异有统计学意义(P<0.05)。对照组疗效评价总有效38例、总有效率为79.17%(38/48),观察组疗效评价总有效45例、总有效率为93.75%(45/48),2组总有效率比较差异有统计学意义(P<0.05)。观察组患者的肠球菌、肠杆菌以及酵母菌数量明显少于对照组,而双歧杆菌、乳酸杆菌数量明显多于对照组,2组比较均差异有统计学意义(P<0.05)。[结论]对胃食管反流病患者在质子泵抑制剂和益生菌的基础上应用曲美布汀进行治疗,不仅能够显著改善患者的临床症状和体征,增加食管的运动能力,而且能够显著改善患者肠道菌群状态,值得临床上进一步研究应用。
[Objective]To observe the effect of trimebutine combined with proton pump inhibitor and probiotics on clinical efficacy and intestinal flora in patients with gastroesophageal reflux disease.[Methods]We selected 96 patients with gastroesophageal reflux disease admitted to our hospital from September 2017 to December 2018.According to the principle of random number method,they were divided into control group(48 cases)and observation group(48 cases).Patients in control group were given Omeprazole enteric-coated tablets 40 mg before meals,two times a day(morning and evening),and 630 mg Bifidobacterium triple viable capsule orally,two times a day.The patients in observation group accepted trimebutine tablets 100 mg oral,three times a day on the basis of the treatment in the control group.After 12 weeks of continuous treatment,the efficacy,distal contractile integral(DCI),GerdQ scores,symptoms and frequency of onset,and changes of intestinal flora were evaluated.[Results]Before treatment,there was no significant difference in GerdQ score,DCI,high resolusion manometry(HRM),frequency of symptoms and intestinal flora distribution between the two groups(P>0.05);After treatment,the DCI level,LES resting pressure in the observation group was significantly higher than that in the control group,and the scores of GerdQ,UES resting pressure symptoms and seizure frequency were significantly lower than those of the control group,there were significant differences between the two groups(P<0.05).The total effective cases of the control group was 38 cases,the total effective rate was 79.17%(38/48),and the total effective cases of the observation group was 45 cases,the total effective rate was 93.75%(45/48).There was significant difference between the two groups(P<0.05).The number of enterococcus,enterobacter and yeast in the observation group were significantly less than those in the control group,and the number of bifidobacterium and lactobacillus was significantly higher than those of the control group,there were significant differences between the two groups(P<0.05).[Conclusion]The use of trimebutine on the basis of proton pump inhibitors and probiotics in the treatment of gastroesophageal reflux disease can not only improve the clinical symptoms and signs of patients,it also increases the motor ability of the esophagus and improve the intestinal flora status of patients,which is worth further study and application in clinic.
作者
王松
肖丹
陈兰
夏伶俐
WANG Song;XMO Dan;CHEN Lan;XIA Ling-li(Internal Medicine,the Sixth Hospital of Wuhan Affiliated Hospital of Jianghan University,430015 Wuhan,China;Department of Gastroenterology,the Sixth Hosp让al of Wuhan Affiliated Hospital of Jianghan University,430015 Wuhan,China)
出处
《临床消化病杂志》
2019年第6期349-353,共5页
Chinese Journal of Clinical Gastroenterology
关键词
胃食管反流病
曲美布汀
质子泵抑制剂
益生菌
肠道菌群
gastroesophageal reflux disease
trimebutine
proton pump inhibitor
probiotics
intestinal flora
