Frazzoni M, Manno M, De Micheli E, Savarino V
Internal Medicine and Gastroenterology Unit, New S. Agostino Hospital, Via Martignana 51, Modena 41100, Italy.
Dig Liver Dis. 2006 Feb;38(2):85-90. doi: 10.1016/j.dld.2005.10.001. Epub 2005 Nov 10.
Acid suppression is the mainstay of therapy in gastro-oesophageal reflux disease. Esomeprazole 40 mg is more effective than lansoprazole 30 mg in healing mucosal lesions in severe erosive reflux oesophagitis. However, data comparing esomeprazole with lansoprazole in patients with complications of gastro-oesophageal reflux disease, such as ulcerative reflux oesophagitis and Barrett's oesophagus, are lacking.
To compare the efficacy of esomeprazole and lansoprazole at their standard dosages in suppressing oesophageal acid exposure in complicated gastro-oesophageal reflux disease.
Thirty patients with complicated gastro-oesophageal reflux disease (7 with ulcerative reflux oesophagitis and 23 with Barrett's oesophagus), randomly assigned to receive 40 mg esomeprazole (n=16) or 30 mg lansoprazole (n=14) once daily, underwent oesophageal 24-h pH monitoring while on therapy. Total, upright diurnal and supine nocturnal percentage acid reflux time were assessed.
Esomeprazole was significantly more effective than lansoprazole in decreasing oesophageal acid exposure. Normalisation of both total and supine nocturnal percentage acid reflux time was obtained in 12 of 16 (75%) patients treated with esomeprazole but only in 4 of 14 (28%) cases treated with lansoprazole (p=0.026).
Normalisation of oesophageal acid exposure can be achieved in the majority of complicated gastro-oesophageal reflux disease cases with esomeprazole 40 mg once daily.
抑酸是胃食管反流病治疗的主要手段。在治疗严重糜烂性反流性食管炎的黏膜损伤方面，埃索美拉唑40毫克比兰索拉唑30毫克更有效。然而，缺乏在胃食管反流病并发症患者（如溃疡性反流性食管炎和巴雷特食管）中比较埃索美拉唑和兰索拉唑的数据。
比较埃索美拉唑和兰索拉唑标准剂量在抑制复杂性胃食管反流病食管酸暴露方面的疗效。
30例复杂性胃食管反流病患者（7例溃疡性反流性食管炎患者和23例巴雷特食管患者）被随机分配，分别接受每日一次40毫克埃索美拉唑（n = 16）或30毫克兰索拉唑（n = 14）治疗，治疗期间进行24小时食管pH监测。评估总酸反流时间、直立白天和仰卧夜间酸反流时间百分比。
在减少食管酸暴露方面，埃索美拉唑比兰索拉唑显著更有效。接受埃索美拉唑治疗的16例患者中有12例（75%）总酸反流时间和仰卧夜间酸反流时间百分比恢复正常，而接受兰索拉唑治疗的14例患者中只有4例（28%）恢复正常（p = 0.026）。
对于大多数复杂性胃食管反流病病例，每日一次服用40毫克埃索美拉唑可实现食管酸暴露正常化。
