刘国华++杨土英++林红

[摘要] 目的 比较雷贝拉唑与雷尼替丁治疗非糜烂性胃食管反流病的疗效与安全性。 方法 本研究采用单中心的半随机单盲设计，将110例胃食管反流病患者分为两组，A组（n=57）给予雷贝拉唑治疗，每次20 mg，每天2次；B组（n=53）给予雷尼替丁治疗，每次150 mg，每天2次，为期 8周。所有患者均经胃镜检查证实食管黏膜无异常。采用生活质量评分与药物不良反应事件作为有效性与安全性的观测指标。 结果 110例患者中96例（A组52例，B组44例）完成了整个治疗过程后，显示雷贝拉唑组患者平均生活质量提高程度优于雷尼替丁组，差异有统计学意义（QOLA+：32.12±1.73，QOLB+：23.48±1.73，P=0.001）。对于不良反应事件，雷贝拉唑为11例（19.3%），雷尼替丁为13例（24.5%），两组无统计学差异（P=0.507）。 结论 在提高生活质量方面，雷贝拉唑较雷尼替丁效果好，但对于安全性方面，两者无差异。

[关键词] 雷贝拉唑；雷尼替丁；非糜烂性胃食管反流病；生活质量；不良反应

[中图分类号] R512.62 [文献标识码] B [文章编号] 1673-9701（2017）03-0030-03

Comparison of the efficacy and safety of rabeprazole and ranitidine in the treatment of non-erosive gastroesophageal reflux disease

LIU Guohua YANG Tuying LIN Hong

Department of Gastroenterology， Qingxi Hospital of Dongguan City in Guangdong Province， Dongguan 523660， China

[Abstract] Objective To compare the efficacy and safety of rabeprazole and ranitidine in the treatment of non-erosive gastroesophageal reflux disease. Methods In this study， a single-center semi-randomized single-blind design was used. 110 patients with gastroesophageal reflux disease were randomly divided into two groups. Group A（n=57） was given rabeprazole of 20 mg twice daily. Group B（n=53） was given ranitidine of 150 mg twice daily for 8 weeks. All patients were given endoscopic examination which confirmed no abnormal esophageal mucosa. The score of the quality of life was applied and adverse drug reactions were selected as the observation indicators of efficacy and safety. Results After 96 patients（56 patients in group A and 44 cases in group B） out of 110 patients had completed the whole course of treatment， the average quality of life in the rabeprazole group was higher than that in the ranitidine group， and the results were statistically significant（QOLA+： 32.12±1.73， QOLB+： 23.48±1.73， P=0.001）. For the adverse events， there were 11 cases（19.3%） in rabeprazole group and there were 13 cases（24.5%） in ranitidine group. There was no significant difference between the two groups（P=0.507）. Conclusion In improving the quality of life， rabeprazole is more effective than ranitidine， but for safety， there is no difference between the two group.

[Key words] Rabeprazole； Ranitidine； Non-erosive gastroesophageal reflux disease； Quality of life； Adverse reactions

胃食管反流病（gastroesophageal reflux disease，GERD）是消化系统中常见、易复发的慢性疾病之一，是由胃及十二指肠内容物反流至食管引起一些不良反应的症状，其中包括胃灼热、反流、烧心、喉咙不适、咳嗽，甚至可引起哮喘等症状[1，2]。相关研究[3]证实，如果GERD未得到及时有效的治疗，食管反复受刺激可能发展为Barrett食管或食管腺癌。根据其内镜下表现可以将GERD分为：非糜烂性反流病（non-erosive reflux disease，NERD）、糜烂性食管炎（EE）、Barrett食管（BE），非糜烂性反流病是其中最常见一种亚型[4，5]，其定义是：存在反流相关的不适症状，但内镜下未见BE和食管黏膜破损[6]。……