根除幽门螺杆菌与胃食管反流病疗效间的关系研究-内科学专业论文.docxVIP

重庆医 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 GERD 英文全称 Gastroesophageal Reflux Disease 中文全称 胃食管反流病 NERD EE LES TLSER Non-erosive Reflux Disease Erosive Esophagitis Lower Esophageal Sphincter Transit LES Relaxation 非糜烂性反流病 糜烂性食管炎 食管下括约肌 一过性食管下括约 肌松弛 Hp PPI Helicobacter Pylori Proton Pump Inhibitors 幽门螺杆菌 质子泵抑制剂 RGERD Refractory Gastroesophageal Reflux Disease MII-pH Multichannel Intraluminal Impedance and pH Monitoring 难治性胃食管反流 病 食管腔内多通道阻 抗-pH 技术 H2RA H2 Receptor Antagonist H2 受体拮抗剂 LNF Laparoscopic Nissen Fundoplication 腹腔镜 Nissen 胃底 折叠术 BMI Body Mass Index 体质指数 1 根除幽门螺杆菌与胃食管反流病疗效间的关系研究 摘 要 目的：探讨根除幽门螺杆菌（Hp）与胃食管反流病（GERD）疗 效间的关系。 方法：选取GERD患者254例，分为非糜烂性反流病(NERD)组和 糜烂性食管炎（EE）组，再进一步分为Hp阳性组、Hp阴性组，Hp阳 性组随机分为不抗Hp治疗组和抗Hp治疗组，抗Hp组行以质子泵抑制剂 PPI（雷贝拉唑）为核心的Hp根除三联疗法，疗程10天；不抗Hp组和 Hp阴性组仅服用PPI（雷贝拉唑)10天；10天后所有患者仅服用PPI直至 试验总疗程2个月。试验结束时仅EE组行胃镜检查，所有患者均行食管 酸反流测定和13C呼气试验检测Hp。 结果：179例患者完成了临床研究（NERD组119例，其中抗Hp治 疗组47例，不抗Hp组32例，Hp阴性组40例；EE组60例，其中抗Hp组 24例，不抗Hp组15例，Hp阴性组21例），NERD中抗Hp组36例患者Hp 转阴（76.6%），EE组中抗Hp组18例Hp转阴（75%）；NERD或EE组中Hp 根除成功患者组分别与Hp根除失败组、不抗Hp组、Hp阴性组在治疗前 后症状、食管炎症和食管酸反流方面比较无显著差异（P0.05）。 结论：根除Hp治疗与GERD疗效间没有明显相关性。 关键词：幽门螺杆菌；Hp根除；胃食管反流病；疗效 2 THE RELATIONSHIP BETWEEN HELICOBACTER PYLORI ERADICATION AND CURATIVE EFFECT OF GASTROESOPHAGEAL REFLUX DISEASE ABSTRACT OBJECTIVE：To investigate the relationship between Hp eradication and curative effect of gastroesophageal reflux disease(GERD) . METHODS：Two hundred and fifty four patients with GERD were prospectively recruited for endoscope and acid reflux evaluation.according to the results of gastroscope,The eligible patients were divided into non-erosive reflux disease (NERD) and erosive esophagitis (EE) group ,and each divided into Hp positive and Hp negative group, the Hp positive group were randomly divided into the anti Hp treatment group and not.These patients were assigned to rabeprazole triple therapy(the anti Hp treatment group) or rabeprazole(20mg，twice per day) single(other groups) for ten days,Then rabeprazole (20mg，twice per