本文選題：胃食管反流病 + 食管下括約肌�。� 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：通過觀察膈肌生物反饋訓(xùn)練(Diaphragm boifeedback training DBT)對食管下括約肌靜息壓、靜息膈腳張力、最大膈腳張力以及對GerdQ (Gastroesophageal reflux disease question胃食管反流病問卷)評分的影響,觀察DBT對GERD (Gastroesophageal reflux disease胃食管反流病)的改善狀況,以及對降低GERD復(fù)發(fā)的影響,以此探討DBT對GERD的療效。 方法：將60例初始確診GERD的患者隨機(jī)分為3組,每組20例,第1組為PPI(proton pump inhibitor,質(zhì)子泵抑制劑)+DBT組、第2組為PPI組,第3組為DBT組。PPI+DBT組生物反饋治療15分鐘2/日+雷貝拉唑腸溶膠囊20mg1/日口服；PPI組雷貝拉唑腸溶膠囊20mg1/日口服；DBT組生物反饋治療15分鐘2/日。分別于治療前、2周后及4周后對三組患者進(jìn)行下食管括約肌靜息壓、靜息膈腳張力、最大膈腳張力檢測,行GerdQ評分。治療4周后前兩組患者停用藥物,第1組及第3組患者繼續(xù)堅持DBT治療,在8周時再次檢測上述指標(biāo)并行GerdQ評分,評價復(fù)發(fā)情況。 結(jié)果：DBT組及PPI+DBT組患者食管下括約肌靜息壓、靜息膈腳張力、最大膈腳張力在治療2周后、4周后均有提高,其中靜息膈腳張力的變化有統(tǒng)計學(xué)意義(P0.05)。三組患者在治療2周末、4周末GerdQ評分均有明顯下降,PPI+DBT下降更為顯著,PPI+DBT組與PPI組間比較,差異有統(tǒng)計學(xué)意義,(P0.05)。8周后PPI+DBT組及DBT組患者的靜息膈腳張力、GerdQ評分與PPI組之間比較差異均有統(tǒng)計學(xué)意義(P0.05)。PPI組食管下括約肌靜息壓、靜息膈腳張力、最大膈腳張力在治療2周后、4周后均無明顯變化(P0.05)。 結(jié)論：生物反饋訓(xùn)練治療,可以提高GERD患者靜息膈腳張力,明顯改善患者陽性癥狀,進(jìn)而提高GERD患者療效。在患者的后期治療中有望替代PPI藥物而成為鞏固療效的一種有效治療方法。
[Abstract]:Objective: to observe the effects of diaphragm biofeedback training on resting pressure of lower esophageal sphincter, resting phrenic foot tension, maximum phrenic foot tension and the score of GerdQ Gastroesophageal reflux disease question gastroesophageal reflux disease (GERD). To observe the effect of reflux disease on gastroesophageal reflux disease (GERD) and to reduce the recurrence of GERD, 60 patients with GERD were randomly divided into 3 groups, 20 cases in each group. The first group was PPIproton pump inhibitor (proton pump inhibitor) DBT, and the second group was PPI group. The third group was treated with biofeedback for 15 minutes, 2 minutes / day, 2 minutes, 2 minutes and 2 days respectively in group 3. The rats in group 3 were treated with rabeprazole enteric-coated capsule 20mg1/ for 15 minutes and 2 days after oral administration of Rabeprazole enteric-coated capsule 20mg1/. The resting pressure of lower esophageal sphincter, resting phrenic foot tension and maximal phrenic foot tension were measured 2 weeks before treatment and 4 weeks after treatment. GerdQ score was used. After 4 weeks of treatment, the patients in the first two groups stopped taking drugs, and the patients in the first and third groups continued to be treated with DBT. After 8 weeks of treatment, the above indexes were measured again with GerdQ score to evaluate the recurrence. Results the resting pressure of the lower esophageal sphincter was evaluated in the group of 20 DBT and the group of PPI DBT. The resting phrenic foot tension and the maximum phrenic foot tension increased after 2 weeks and 4 weeks after treatment, among which the change of resting phrenic foot tension was statistically significant (P 0.05). The GerdQ scores of the three groups were significantly decreased at the end of 2 weeks and 4 weeks after treatment. The decrease of PPI DBT was more significant than that of PPI DBT group and PPI DBT group. There were significant differences in the resting phrenic foot tension and GerdQ score between PPI DBT group and DBT group and between PPI group and PPI group after P0.05.8 weeks. There were significant differences in resting sphincter resting pressure and resting phrenic foot tension between PPI group and PPI group. The maximal phrenic foot tension did not change significantly after 2 weeks or 4 weeks of treatment. Conclusion: biofeedback training can improve resting phrenic foot tension in patients with GERD, improve the positive symptoms of patients with GERD, and then improve the curative effect of GERD patients. It is expected that PPI can be substituted for PPI in the later stage of treatment.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R571

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相關(guān)期刊論文 前10條

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本文編號：1988402