目的 研究莫沙必利聯(lián)合雷貝拉唑鈉治療反流性食管炎的臨床療效。方法 選取2014年7月-2015年12月中山市陳星海醫(yī)院消化內(nèi)科收治的反流性食管炎患者60例，隨機(jī)分為對(duì)照組和治療組，每組各30例。對(duì)照組口服雷貝拉唑鈉腸溶片，1片/次，1次/d。治療組在對(duì)照組治療基礎(chǔ)上口服枸櫞酸莫沙必利膠囊，1粒/次，3次/d。兩組均連續(xù)治療8周。觀察兩組的臨床療效，比較兩組癥狀改善情況和內(nèi)鏡分級(jí)情況。比較兩組一氧化氮（NO）水平變化和復(fù)發(fā)情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為70.00%、93.33%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組燒心感、反酸、胸骨后灼痛患者例數(shù)均顯著減少，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組治療后這些患者例數(shù)少于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組內(nèi)鏡0級(jí)人數(shù)顯著增多，Ⅰ級(jí)、Ⅲ級(jí)人數(shù)顯著減少，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組內(nèi)鏡0級(jí)人數(shù)多于對(duì)照組，Ⅱ級(jí)、Ⅲ級(jí)人數(shù)少于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療第4、8周，兩組NO水平均較治療前顯著降低，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組NO低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組和治療組的復(fù)發(fā)率分別為36.36%、7.69%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 莫沙必利聯(lián)合雷貝拉唑治療反流性食管炎具有較好的臨床療效，可改善患者的臨床癥狀和內(nèi)鏡分級(jí)情況，降低NO水平和復(fù)發(fā)率，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To analyze the clinical efficacy of mosapride combined with rabeprazole in treatment of reflux esophagitis. Methods Patients (60 cases) with reflux esophagitis in Department of Gastroenterology of Chenxinghai Hospital of Zhongshan City from July 2014 to December 2015 were randomly divided into control and treatment groups, and each group had 30 cases. The patients in the control group were po administered with Rabeprazole Sodium Enteric-coated Tablets, 1 tablet/time, once daily. The patients in the treatment group were po administered with Mosapride Citrate Capsules on the basis of the control group, 1 grain/time, three times daily. The patients in two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and the changes of symptoms improvement and endoscopic classification in two groups were compared. The levels of NO and recurrence in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.00% and 93.33%, respectively, and there were differences between two groups (P<0.05). After treatment, the cases of heartburn, acid reflux, and retrosternal burning pain in two groups were significantly reduced, and the difference was statistically significant in the same group (P<0.05). After treatment, the cases of this kind of patients in the treatment group were less than those in the control group, with significant difference between two groups (P<0.05). After treatment, the number of endoscopy level 0 in two groups significantly were increased, and the number of level I and Ⅲ significantly reduced, and the difference was statistically significant in the same group (P<0.05). After treatment, the number of endoscopy level 0 in the treatment group were more than those in the control group, and endoscopic level I and Ⅲ in the treatment group were less than those in the control group, with significant difference between two groups (P<0.05). After treatment of 4 and 8 weeks, the levels of NO in two groups were significantly reduced, and the difference was statistically significant in the same group (P<0.05). After treatment, the NO in the treatment group was lower than that in the control group, with significant difference between two groups (P<0.05). After treatment, the recurrence rate in the control and treatment groups were 36.36% and 7.69%, respectively, and there were differences between two groups (P<0.05). Conclusion s Mosapride combined with rabeprazole has clinical curative effect in treatment of reflux esophagitis, and can improve the clinical symptoms and endoscopic classification, also can reduce NO and the recurrence rate, which has a certain clinical application value.

中山市醫(yī)學(xué)科研基金項(xiàng)目（2015J179）