ObjectivesTo systematically review the efficacy and safety of esomeprazole versus omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of esomeprazole versus omeprazole in the treatment of ANVUGIB from inception to January, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 RCTs involving 2 086 patients were included. The results of meta-analysis showed that, the total effective rate of esomeprazole group was higher than omeprazole group (RR=1.09, 95%CI 1.04 to 1.14, P=0.000 6), the incidence of adverse reactions was lower than omeprazole group (OR=0.27, 95%CI 0.18 to 0.40, P<0.000 01), the average hemostasis time was shorter than omeprazole group (MD=?0.64, 95%CI ?0.94 to ?0.34, P<0.0001), and the difference were statistically significant.ConclusionsCurrent evidence shows that in the treatment of ANVUGIB, esomeprazole has rapid hemostasis, significant effect and fewer adverse reactions, which is worthy of wide application and promotion. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo explore and analyze the clinical diagnosis and treatment of gastroesophageal reflux disease (GERD) which is manifested mainly as stubborn pharyngitis. MethodsFrom February 2010 to December 2012, 79 cases were diagnosed as stubborn pharyngitis and otolaryngology standard treatment was invalid. GERD questionnaire ratings and conventional endoscopy were performed for patients with obvious manifestations of stubborn pharyngitis shown on the laryngoscopy. They were randomly divided into treatment group (n=40) and control group (n=39). Patients in the treatment group accepted esomeprazole 40 mg, qd, for 12 weeks; and patients in the control group had sucralfate suspension 15 mL bid for 12 weeks. At the three observation points which are 4, 8, and 12 weeks after treatment began, clinical symptom score and pharyngeal inflammatory changes were recorded, and at the end of the treatment, all patients underwent endoscopy, and esophageal mucosal healing was observed. ResultsThere was no significant difference between the two groups of patients in terms of general data. After the treatment, the symptom scores were significantly decreased in the treatment group at the three observation points (P<0.05). The same situation happened also in the control group, but the difference was not significant (P>0.05). The symptom scores between the two groups after treatment were significantly different (P<0.5). And the effective rate for local pharyngeal infection was 83.9% and 41.4% in the treatment group and the control group respectively (P<0.05). ConclusionSome atypical GERDs feature by the symptoms of stubborn pharyngitis. Clinically, patients with long-term stubborn pharyngitis should be screened to exclude the possibility of GERD. esomeprazole therapy can significantly improve the pharyngitis symptoms and relieve local inflammation.
目的:探討內鏡下氬離子凝固術(APC)聯合抑酸治療對Barrett食管的臨床療效。方法:選擇經內鏡及病理確診的Barrett食管患者40例,隨機分為兩組,治療組21例,對照組19例,治療組經內鏡下APC治療后聯合埃索美拉唑20mg 2次/日連續3月,對照組單用埃索美拉唑20mg 2次/日連續3月,分別于3月、6月、12月對兩組進行臨床癥狀積分和內鏡及病理隨訪。結果:兩組治療后3、6、12月臨床癥狀積分緩解無明顯差異性(Plt;0.05),但從內鏡、病理隨訪的有效率來看,治療組與對照組相比有顯著差異性(Plt;0.05)。結論:BE內鏡下APC聯合抑酸治療能有效逆轉Barrett上皮,是一種安全、有效的治療方法。
目的 采用高效液相色譜法測定受試者口服埃索美拉唑腸溶膠囊與埃索美拉唑鎂腸溶片后血藥濃度，評價埃索美拉唑腸溶膠囊的生物等效性。 方法 2009年9月－10月，36例健康男性受試者單次交叉口服埃索美拉唑腸溶膠囊（試驗制劑）和埃索美拉唑鎂腸溶片（參比制劑），測定給藥后不同時間點血漿中埃索美拉唑經時血藥濃度，采用DAS 2.0軟件進行藥物代謝動力學參數計算和生物等效性評價。 結果 受試者單次口服試驗制劑與參比制劑后，達峰時間分別為（2.19 ± 0.96）、（2.43 ± 0.92） h，峰濃度分別為（1 748.86 ± 615.81）、（1 442.92 ± 476.41） μg/L，藥時曲線下面積（AUC）0-t分別為（3 927.14 ± 1 839.10）、（3 878.79 ± 1 734.84） μg/L·h，AUC0-∞分別為（3 998.36 ± 1 866.22）、（3 918.31 ± 1 773.44） μg/L·h。試驗制劑與參比制劑的生物等效性為94.0%，其90%CI為（82.3%，107.2%）。 結論 埃索美拉唑腸溶膠囊與埃索美拉唑鎂腸溶片生物等效。