胃食管反流病发病机制与治疗进展

(GERD)GERD(),30%GERD,10%,GERD,,,,GERD,GERD,;;R57A1606-8106(2007)11-0986-04(Gastroesophagealrefluxdisease,GERD),GERDGERDGERD,(Refluxesophagitis,RE)GERD2/3;GERD,GERD1/3Barretts,[1],(non-erosiverefluxdisease,NERD)RE,[2],NERDRE,,,()10.19%,7.76%,GERD5.77%,1.92%[3]1GERD,,,()(:300300,)1.1,(LES)GERD,,LESLES(TLESR),TLESRGERD,TLESRWong[4],GERDTLESR,12,,GERD,Chrysos[5],GERD,LES,,,,Barrett,,[6],48.6%GERDNERD,,GERDGERD,(MMC),MMC,,REGERD,,RE,,689ChineseJournalofTraditional&WesternMedicine2007811,,,GERD,GERD[7]1.2GERD,RE,GERD,,,GERD,,,,pH[8]GERD,Bilitec2000,GERDBryanT.Green,J.BarryO’Connor[9]24h,,97324hpH,5%,12%(),,86%,64.7%,23.5%5.9%Barrett[10],REBE,REBE24hpHNERD,24hRE,BENERDREBE,[11],,,2GERD,,,,,1520cm,:2.1GERD,GERD[12]pH=4,pH4,,,pH4GERD,pH4GERD,,GERD24hpH418h[12],,,(PPI):(GERD),,H+,K+-ATP,30minPPI5PPI(),[13]524140mg/d(30min)30mg/d(30min),892.6%,88.8%5,pH414.0h,(12.1h)(11.8h)(11.3h)(10.1h),P0.001,,,,24h,pH,[14],PPI,,30mg/d,8GERD91%300mg266%PPIH2RA789ChineseJournalofTraditional&WesternMedicine2007811GERDREH2(H2RA):H2RA,PPIH2,2,3,57%,58%2.2GERD,,,LES,,5-4(5-HT4),,,,,,LES,,,,[15]10mg,4150mg,28,RE62.8%50%(MosaprideCitrateTablets),5-HT4,,,,,-,,,,,[16]QT,[17][18],-(GABAB)(baclofen)TLESR,GERD,LES,,2.3,,,,,[19],,,,,,,2.4HpPPIHpGERDHpGERDPPI,HpGERDPPI,GERDHp,HpGERD,HpGERD,,HpGERD,Hp,PPIHpGERD,[20]2.5,H2RA;,H2RA,,PPI,,,,PPI,23,,,H2RA;(stepup),,H2RA,,PPI,,,[21]GERD,,:(1)RE;(2);(3);(4)H2RAPPI889ChineseJournalofTraditional&WesternMedicine20078111,..:,2002,251-264.2,..,2004,43(1):69-70.3,,,..,1999,19(4):3.4WongWM,LaiKC,HuiWM,etal.AmJGastroenterol,2004,99:2088-2093.5Chr4ysosE,ProkopakisG,AthanasakisE,etal.ArchSurg,2003,138:241-246.6,,..,2004,12(6):1502-1504.7CalabreseC,FabbriA,BortolottiM,etal.AlimentPharmacolTher,2003,18:525-532.8,..,2005,44:6-7.9BryanT,GreenJ,BarryO’Connor.DigestiveDiseasesandSciences,2004,49(7-8):1084-1087.10..:,2002,45-61.11,..,2005,25:434-435.12,..,2003,3:178-179.13PhilipM,PhilipD,YusongC,etal.Gastricacidcontrolwithes-omeprazole,lansoprazol,omeprazole,pantoprazoleandrabeprazole:afive-waycrossoverstuty.AmJGastroenterol,2003,98:2616-2620.14..,2003,1:46.15,..,2001,10(7):618.16,,..,2004,10:638-639.17CarlssonL,AmosGJ,AnderssonB,etal.Electrophysiologicalcharacterizationoftheprokineticagentscisaprideandmosaprideinvivoandinvitro:Implicationsforproarrhymicpotential.JPharmacolExpTher,1997,282(1):220-227.18LidumsI,LehmannA,ChecklinH,etal.ControloftransientloweresophagealsphincterrelaxationsandrefluxbytheGABABagonistBaclofeninnormalsubjects.Gastroenterology,2000,118(1):7-13.19..,2006,6:377-378.20,,..,2000,8(10):1133-1134.21..,2000,2:76-78.(:)1,2()R737.3A1606-8106(2007)11-0989-04,,,,,1Ia:1545400,2,,Bokhman,25%Ia[1](medroxyprogesteroneacetate,MPA)(megestrolacetate)(),,200800mg,414;,40160mg[2]62%76%I39989ChineseJournalofTraditional&WesternMedicine2007811