ObjectivesTo systematically review the efficacy and safety of hydrotalcite in the treatment of reflux esophagitis (RE).MethodsCBM, CNKI, WanFang Data, VIP, PubMed, EMbase, The Cochrane Library, Web of Science and Scopus databases were searched online to collect randomized clinical trials (RCTs) of hydrotalcite or hydrotalcite plus PPI versus PPI alone in the treatment of RE from inception to June 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 1 655 patients were included. The results of meta-analysis showed that: after 4-8 weeks of treatment, there was no significant difference between hydrotalcite vs. PPI regarding RE healing rates (RR=0.87, 95%CI 0.76 to 1.00, P=0.05). However, there were significant increases in RE healing rate (RR=1.22, 95%CI 1.14 to 1.31, P<0.001) and symptom relief rate (RR=1.36, 95%CI 1.12 to 1.66,P<0.01) between hydrotalcite plus PPIvs. PPI alone. Similar increases of RE healing rate (RR=1.16, 95%CI 1.08 to 1.25, P<0.001) and symptom relief rate (RR=1.12, 95%CI 1.04 to 1.20,P<0.01) were seen in patients with refractory RE. No increase of adverse effect rate was shown with hydrotalcite or hydrotalcite plus PPI compared to PPI alone.ConclusionsCompared with PPI alone, hydrotalcite plus PPI confers a statistically significant improvement of healing rate and symptom relief rate, while it does not increase adverse effect rate. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
目的 探討和分析反流性食管炎與幽門螺桿菌感染之間的關系。 方法 回顧性分析2009年1月－2011年11月間胃鏡確診為反流性食管炎334例，所有患者均行快速尿素酶試驗；其中反流性食管炎合并消化性漬瘍57例，慢性非萎縮性胃炎102例。 結果 反流性食管炎的幽門螺桿菌感染率為21.6% ，在幽門螺桿菌感染陽性的患者中最多見并發消化性潰瘍，而在幽門螺桿菌感染陰性的患者中最多見并發慢性非萎縮性胃炎，解剖結構和動力障礙性疾病絕大多數并發于幽門螺桿菌陰性患者。A和B級反流性食管炎的幽門螺桿菌感染陰性的患者多于幽門螺桿菌感染陽性的患者。在A級反流性食管炎中幽門螺桿菌感染率28.0%，B級為8.4%，C+D級為0.0%。 結論 反流性食管炎中幽門螺桿菌感染率低，幽門螺桿菌陽性的反流性食管炎多并發于消化性潰瘍，提示幽門螺旋桿菌對反流性食管炎發病有一定保護作用。
目的 觀察生姜瀉心湯治療反流性食管炎的臨床療效。 方法 2006年2月-2008年3月，回顧性分析20例反流性食管炎患者，服用生姜瀉心湯7 d后，停藥觀察1個月，應用反流性疾病問卷及胃鏡檢查，判斷治療效果。 結果 治愈率為35%，有效率為90％。 結論 生姜瀉心湯對反流性食管炎有較好的臨床療效。
目的 研究質子泵抑制劑在反流性食管炎維持治療的臨床療效。 方法 將2009年3月-月門診及住院的121例反流性食管炎并胃鏡證實病灶已愈合，且停藥1周內癥狀又復發者，隨機分為A、B、C 3組，3組均選用蘭索拉唑。A組為蘭索拉唑15 mg，1次/d，早餐前服；B組為蘭索拉唑15 mg，1次/d，晚餐前服；C組蘭索拉唑15 mg，2次/d，餐前服。3組療程均為4周。療程結束后進行臨床癥狀療效評定，并予復查胃鏡，評價3組胃鏡下總有效率，并觀察3組不良反應。 結果 三種方案有效率分別為77.5%、95.0%、92.7%。 結論 晚餐前15 mg 1次/d的蘭索拉唑為反流性食管炎較佳維持治療方案。