Córdova-Villalobos J A, Ramírez-Barba E J, Ramírez-Covarrubias J C
Hospital de Especialidades IMSS León, Universidad de Guanajuato, Facultad de Medicina de León.
Rev Gastroenterol Mex. 1996 Oct-Dec;61(4):306-9.
Reflux Esophagitis is a common complaint from the upper gastrointestinal tract with a figured out prevalence of about 2%. Therapeutic results in this pathology have been unsatisfactory.
To compare lansoprazole and omeprazole therapeutic effects in patients with reflux esophagitis.
A clinical, double-blinded, balanced survey was randomly designed with patients who would daily receive 30 mg lansoprazole (Group A) or 20 mg omeprazole (Group B) during a 4-week period. All patients were submitted to endoscopy and biopsy both at the beginning and at the end of the survey.
Ten patients in each group were treated without any significant differences in sex, age, nicotinism, alcoholism, AINES ingestion, development time, pain regurgitations, pyrrosis, hematemesis, dysphagia, melena, nausea or vomiting, and esophagitis degree. A complete cure in 8/10 (omeprazole) and 7/10 (lansoprazole) patients was obtained (p = n.s.). However, the histological results of the biopsy at the end of the four-week period proved to be a failure in 4/10 (omeprazole) and in 5/10 (lansoprazole) patients (p = n.s.). The endoscopy and clinical result at the end of the study were similarly effective; but not so the histological damage to the esophagus, which continues to be important.
The use of bomb inhibitors in esophagitis by reflux is advisable. Future surveys must assess the average time of treatment for the disappearance of the histologic lesion.
反流性食管炎是上消化道的常见病症,患病率约为2%。该病症的治疗效果一直不尽人意。
比较兰索拉唑和奥美拉唑对反流性食管炎患者的治疗效果。
随机设计一项临床双盲均衡研究,让患者在4周内每日服用30毫克兰索拉唑(A组)或20毫克奥美拉唑(B组)。所有患者在研究开始和结束时均接受内镜检查和活检。
每组10名患者接受治疗,在性别、年龄、吸烟、酗酒、服用非甾体抗炎药、发病时间、疼痛性反流、烧心、呕血、吞咽困难、黑便、恶心或呕吐以及食管炎程度方面无显著差异。奥美拉唑组8/10例和兰索拉唑组7/10例患者实现完全治愈(p = 无统计学意义)。然而,四周结束时活检的组织学结果显示,奥美拉唑组4/10例和兰索拉唑组5/10例患者治疗失败(p = 无统计学意义)。研究结束时的内镜检查和临床结果同样有效;但食管的组织学损伤情况并非如此,其仍然较为严重。
对于反流性食管炎,使用质子泵抑制剂是可取的。未来的研究必须评估组织学病变消失所需的平均治疗时间。