Saco L S, Orlando R C, Levinson S L, Bozymski E M, Jones J D, Frakes J T
Gastroenterology. 1982 Jun;82(6):1369-73.
To determine the value of bethanechol in the treatment of erosive esophagitis, a double-blind study was undertaken in which 28 patients were randomized to either bethanechol and antacid, or placebo and antacid. Patients were evaluated clinically, endoscopically, and by esophageal manometry before and after 8 wk of therapy. After treatment both groups showed significant improvement in heartburn and in healing of esophageal lesions. Patients who received bethanechol plus antacids did not show a greater improvement than patients who received placebo plus antacids in any category, nor did patients in the bethanechol-treated group have a greater incidence of complete healing. In addition, pretreatment mean lower esophageal sphincter pressure was normal in approximately 30% of patients with erosive esophagitis and this finding was associated with a greater chance for complete healing of esophageal lesions. These results fail to show that the addition of bethanechol to an intensive antacid regimen is more effective than the antacid regimen alone in the treatment of erosive esophagitis and that patients with esophagitis and normal lower esophageal sphincter pressures respond more favorably to medical treatment.
为了确定氨甲酰甲胆碱在糜烂性食管炎治疗中的价值，进行了一项双盲研究，将28例患者随机分为氨甲酰甲胆碱加抗酸剂组或安慰剂加抗酸剂组。在治疗8周前后，对患者进行临床、内镜及食管测压评估。治疗后，两组患者的烧心症状及食管病变愈合情况均有显著改善。在任何一项指标上，接受氨甲酰甲胆碱加抗酸剂治疗的患者均未比接受安慰剂加抗酸剂治疗的患者有更明显的改善，氨甲酰甲胆碱治疗组患者的完全愈合发生率也未更高。此外，约30%的糜烂性食管炎患者治疗前食管下括约肌压力正常，这一发现与食管病变完全愈合的可能性更大相关。这些结果未能表明，在强化抗酸治疗方案中加用氨甲酰甲胆碱比单纯抗酸治疗方案在糜烂性食管炎治疗中更有效，也未能表明食管炎且食管下括约肌压力正常的患者对药物治疗反应更佳。
