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摘要: 目的 观察伏诺拉生治疗反流性食管炎的临床疗效。方法 回顾性分析2021年3月—2022年3月我院门诊诊治的70例确诊反流性食管炎患者的临床资料，根据治疗药物不同，分为观察组(口服伏诺拉生治疗，32例)和对照组(口服雷贝拉唑治疗，38例)，比较2组患者临床症状积分、临床疗效、食管黏膜愈合情况、成本-效果分析、不良反应发生率。结果 2组患者药物治疗后临床症状积分均较治疗前降低，观察组治疗后积分显著低于对照组[(0.90±0.77)分vs(1.57±1.17)分，P < 0.05]；观察组治疗总有效率为高于对照组(96.9% vs 73.7%，P < 0.05)；观察组食管黏膜愈合有效率高于对照组(93.8% vs 68.4%，P < 0.05)；观察组成本/效果比值低于对照组(11.6 vs 13.8)；2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 伏诺拉生能够有效缩短反流性食管炎治疗时间，促进食管黏膜愈合并改善患者临床症状，具有较好的临床推广应用价值。Abstract: Objective To observe the clinical efficacy of vonoprazan in the treatment of reflux esophagitis.Methods Clinical data of 70 patients with reflux esophagitis admitted between March 2021 and March 2022 was retrospectively analyzed. The patients were divided into the observation group (32 cases) and control group(38 cases) according to the therapeutic drugs. The observation group was treated with vonoprazan, while the control group was treated with rabeprazole. Clinical symptom scores, clinical efficacy, endoscopic mucosal healing rate, cost-effectiveness ratio, and incidence rates of adverse reactions were observed in two groups.Results The clinical symptom scores of the two groups were lower than before treatment, and the clinical symptom scores of the patients in the observation group were lower than those of the control group, and the difference was statistically significant[(0.90±0.77) scores vs (1.57±1.17) scores, P < 0.05].The total effective rate in the observation group was higher than the control group, and the differences were statistically significant(96.9% vs 73.7%, P < 0.05).The mucosal healing rate of the observation group was higher than the control group, and the differences were statistically significant(93.8% vs 68.4%, P < 0.05).The ratio of cost-effectiveness in the observation group was lower than in the control group(11.6 vs 13.8).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Vonoprazan can shorten the treatment time of reflux esophagitis, effectively promote the healing of esophageal mucosa, improve the clinical symptoms of patients, and have good clinical promotion and application value.
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Key words:
- reflux esophagitis /
- vonoprazan /
- rabeprazol /
- clinical efficacy /
- cost-effectiveness
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表 1 2组治疗前后临床症状积分比较
分，X±S 组别 例数 治疗前 治疗后 P 观察组 32 4.34±0.97 0.90±0.77 < 0.001 对照组 38 4.50±0.93 1.57±1.17 < 0.001 P 0.493 < 0.001 
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表 2 2组患者临床疗效比较
例(%) 组别 例数 显效 有效 无效 总有效 观察组 32 14(43.7) 17(53.1) 1(3.2) 31(96.9) 对照组 38 12(31.5) 16(42.1) 10(26.4) 28(73.7) P 0.007
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表 3 2组患者内镜黏膜变化比较
例(%) 组别 例数 治愈 有效 无效 总有效 观察组 32 13(40.6) 17(53.1) 2(6.3) 30(93.8) 对照组 38 11(29.0) 15(39.5) 12(31.6) 26(68.4) P 0.008
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[1] 王三强, 许敏光, 魏会珍, 等. 反流性食管炎中医学研究进展[J]. 陕西中医, 2020, 41(2): 266-268. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202002035.htm
[2] 何金杰, 程能能. 钾离子竞争性酸阻断剂——伏诺拉生[J]. 中国临床药学杂志, 2019, 28(3): 219-222. https://www.cnki.com.cn/Article/CJFDTOTAL-LCZZ201903014.htm
[3] 中华医学会消化病学分会. 2020年中国胃食管反流病专家共识[J]. 中华消化杂志, 2020, 40(10): 649-663. doi: 10.3760/cma.j.cn311367-20200918-00558
[4] 桂得权, 朱文涛, 张娜, 等. 药物经济学研究中成本-效果分析法应用现状及存在问题[J]. 中国药房, 2009, 20(11): 805-807. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYA200911006.htm
[5] 曹绍华, 高学德, 张金冉, 等. CYP2C19基因多态性与胃食管反流病质子泵抑制剂治疗疗效的关系[J]. 现代消化及介入诊疗, 2020, 25(7): 889-892. https://www.cnki.com.cn/Article/CJFDTOTAL-XDXH202007015.htm
[6] Kagami T, Sahara S, Ichikawa H, et al. Potent acid inhibition by vonoprazan in comparison with esomeprazole, with reference to CYP2C19 genotype[J]. Aliment Pharmacol Ther, 2016, 43(10): 1048-1059. doi: 10.1111/apt.13588
[7] 姜佳丽, 郭子皓, 李莉, 等. 难治性胃食管反流病159例不同亚型生命质量和精神心理因素研究[J]. 中华消化杂志, 2020, 40(9): 595-600.
[8] 李亚东, 周铖, 赵晨露, 等. 运用加味旋覆代赭汤治疗反流性食管炎经验[J]. 中国中西医结合消化杂志, 2023, 31(4): 308-311. https://zxyxh.whuhzzs.com/article/doi/10.3969/j.issn.1671-038X.2023.04.13
[9] 叶国繁, 朱凌宇, 李凯. 柴麦汤治疗反流性食管炎伴焦虑抑郁的临床疗效观察[J]中国中西医结合消化志, 2022, 30(1): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW202201006.htm
[10] 魏玉娜, 杜秋, 曾明. 标准剂量和双倍剂量质子泵抑制剂对中到重度反流性食管炎内镜治愈率的网状Meta分析[J]. 实用药物与临床, 2017, 20(9): 1022-1029. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC201709031.htm
[11] Otake K, Sakurai Y, Nishida H, et al. Characteristics of the Novel Potassium-Competitive Acid Blocker Vonoprazan Fumarate(TAK-438)[J]. Adv Ther, 2016, 33(7): 1140-1157.
[12] Jung HK. Systematic Review With Meta-analysis: Prompt Endoscopy As the Initial Management Strategy for Uninvestigated Dyspepsia in Asi(Aliment Pharmacol Ther 2015;41: 239-252)[J]. J Neurogastroenterol Motil, 2015, 21(3): 443-444.
[13] Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection[J]. Aliment Pharmacol Ther, 2011, 34(11-12): 1269-1281.
[14] Yacoub R. A meta-analysis of impact of proton pump inhibitors on antiplatelet effect of clopidogrel[J]. Cardiovasc Ther, 2012, 30(6): 357.
[15] Mizokami Y, Oda K, Funao N, et al. Sugano. Vonoprazan prevents ulcer recurrence during long-term NSAID therapy: randomised, lansoprazole-controlled non-inferiorit-y and single-blind extension study[J]. Gut, 2018, 67(6): 1042-1051.
[16] Ashida K, Sakurai Y, Hori T, et al. Randomised clinical trial: vonoprazan, a novel potassium-competitive acid blockervslansoprazole for the healing of erosive oesophagitis[J]. Aliment Pharmacol Ther, 2016, 43(2): 240-251.
[17] Oshima T, Arai E, Taki M, et al. Randomised clinical trial: vonoprazan versus lansoprazole for the initial relief of heartburn in patients with erosive oesophagitis[J]. Aliment Pharmacol Ther, 2019, 49(2): 140-146.
[18] Tanabe T, Hoshino S, Kawami N, et al. Efficacy of long-term maintenance therapy with 10-mg vonoprazan for proton pump inhibitor-resistant reflux esophagitis[J]. Esophagus, 2019, 16(4): 377-381.
[19] 黄博, 崔德军, 赵寻, 等. 伏诺拉生治疗难治性反流性食管炎的临床疗效及安全性[J]. 临床合理用药杂志, 2021, 14(25): 3. https://www.cnki.com.cn/Article/CJFDTOTAL-PLHY202125006.htm
[20] Shichijo S, Hirata Y, Niikura R, et al. Vonoprazan versus conventional proton pump inhibitor-based triple therapy as first-line treatment against Helicobacter pylori: A multicenter retrospective study in clinical practice[J]. J Dig Dis, 2016, 17(10): 670-675.
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