Johnson L F, DeMeester T R
Dig Dis Sci. 1981 Aug;26(8):673-80. doi: 10.1007/BF01316854.
To ascertain how elevation of the head of the bed, bethanechol, and antacid foam tablets affect gastroesophageal reflux, we used prolonged intraesophageal pH monitoring in 55 symptomatic patients. Acid exposure was separated into reflux frequency and esophageal acid clearance time and recorded during the day in the upright posture and recumbent at night. Values before and during each therapy were compared to physiologic reflux in 15 asymptomatic controls. Ten patients slept with the head of the bed elevated and had a 67% improvement in the acid clearance time (P less than 0.025); however, the frequency of reflux episodes remained unchanged. Twelve patients given 25 mg of bethanechol 4 times a day had a 50% decrease in recumbent acid exposure only (P less than 0.05), due to a trend towards decreased reflux episodes and acid clearance in time. Bethanechol combined with head of bed elevation in 19 other patients decreased both reflux frequency (30%) and acid clearance time (53%, all P less than 0.05). Antacid foam tablets failed to significantly diminish acid exposure. Nocturnal reflux responded the best to those therapies tested.
为确定床头抬高、氨甲酰甲胆碱和抗酸泡沫片对胃食管反流的影响，我们对55例有症状的患者进行了长时间食管pH监测。将酸暴露分为反流频率和食管酸清除时间，并在白天直立位和夜间卧位时进行记录。将每种治疗前和治疗期间的值与15例无症状对照者的生理性反流进行比较。10例患者睡觉时床头抬高，酸清除时间改善了67%（P<0.025）；然而，反流发作频率保持不变。12例每天服用4次25mg氨甲酰甲胆碱的患者，仅卧位时的酸暴露减少了50%（P<0.05），这是由于反流发作次数和酸清除时间有减少趋势。在另外19例患者中，氨甲酰甲胆碱联合床头抬高可使反流频率（30%）和酸清除时间（53%，所有P<0.05）均降低。抗酸泡沫片未能显著减少酸暴露。夜间反流对所测试的这些治疗反应最佳。
