目的 通过观察难治性胃食管反流病(rGERD)患者治疗前后精神心理及睡眠情况的变化,探讨阿戈美拉汀联合富马酸伏诺拉生治疗rGERD的效果.方法 选择2021年3月至2021年10月于天津医科大学总医院就诊的54例rGERD患者,分为常规组(26例)和试验组(28例).常规组给予富马酸伏诺拉生治疗,试验组在给予与常规组相同治疗的基础上,联合阿戈美拉汀治疗,疗程均为8周.采用胃食管反流病问卷(GERDQ)、抑郁症筛查量表(PHQ-9)、广泛性焦虑量表(GAD-7)及睡眠障碍评定量表(SDRS)对2组治疗前后的消化道症状、精神心理状态及睡眠情况进行比较,并采用治疗前后各项评分的差值比较2组的疗效.结果 2组患者的性别构成、平均年龄、平均病程,以及治疗前GERDQ、PHQ-9、GAD-7、SDRS评分的差异均无统计学意义(P均>0.05).治疗8周后,常规组治疗后GERDQ评分较治疗前下降[(6.58±0.26)分比(10.00±0.32)分],差异有统计学意义(P<0.05).试验组的治疗后GERDQ、PHQ-9、GAD-7及SDRS评分均较治疗前显著下降[(6.64±0.19)分、(2.86±0.64)分、(1.64±0.54)分、(6.50±0.81)分比(10.93±0.41)分、(8.07±1.05)分、(5.57±0.93)分、(12.50±1.35)分],差异均有统计学意义(P均<0.05).试验组治疗前后的GERDQ、PHQ-9、GAD-7及SDRS评分差值均显著大于常规组[(4.27±0.33)分、(5.21±0.57)分 、(3.93±0.53)分、(6.70±3.72)分比(3.42±0.31)分、(1.62±0.30)分、(0.88±0.37)分、(1.46±0.47)分],差异均有统计学意义(P均<0.05).2组患者治疗后均未发生不良反应.结论 rGERD患者存在精神心理异常和睡眠障碍,阿戈美拉汀联合富马酸伏诺拉生治疗能显著改善rGERD患者的消化道症状,并能缓解睡眠障碍及抑郁、焦虑状态,联合用药的疗效优于单用富马酸伏诺拉生.

深在性囊性胃炎(gastritis cystic profunda,GCP)是一种罕见的胃黏膜下病变,最早由Lettler等[1]在1972年首次发现并报道.1981 年,Franzin等[2]将其正式命名为深在性囊性胃炎(GCP),至今,国内共报道约两百例.现将天津北辰医院消化科收治的1 例GCP病例报道如下,并复习相关文献,以期提高对该病的认识.

神经内分泌肿瘤的生物学特性呈多样化表现,其存在恶变可能,胃肠部位为发生神经内分泌肿瘤的常见位置.在一般情况下,该疾病通常于结肠镜检查中可以发现.病灶很少发生转移,其为一类较为典型的局部、小规格且无功能的肿瘤类型.和以往相比,当前我国医学基础有所进展,在这种情况下,超声内镜检查也得以普及,致使疾病的检出率有所上升,并且内镜下微创治疗的成效也受到了认可.特此,本文全面分析直肠神经内分泌肿瘤超声内镜临床特点,旨意为相关人员的研究工作提供参考文献.

目的 探讨茵芪肝复颗粒联合阿德福韦酯胶囊治疗慢性乙型肝炎肝硬化的临床疗效.方法 选取2016年4月—2019年10月天津市北辰医院收治的119例慢性乙型肝炎肝硬化患者为研究对象,将所有患者根据随机数字表法分为对照组(59例)和治疗组(60例).对照组口服阿德福韦酯胶囊,10 mg/次,1次/d.治疗组患者在对照组的基础上口服茵芪肝复颗粒,18 g/次,3次/d.两组患者疗程为6个月.观察两组临床疗效,比较两组肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、天门冬氨酸氨基转氨酶(AST)]、肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)]、乙肝病毒的脱氧核糖核酸(HBV-DNA)转阴率、乙肝E抗原(HBeAg)转阴率、HBeAg转换率.结果 治疗后,治疗组的临床总有效率为91.67％,高于对照组的74.58％(P<0.05).治疗后,两组患者ALT、AST、TBIL水平均较治疗前下降(P<0.05),且治疗组肝功能指标低于对照组(P<0.05).治疗后,两组患者HA、LN、PC-Ⅲ、Ⅳ-C水平均较治疗前下降(P<0.05),且治疗组肝纤维化指标水平低于对照组(P<0.05).治疗后,治疗组的HBV-DNA转阴率、HBeAg转阴率、HBeAg转换率均高于对照组(P<0.05).结论 茵芪肝复颗粒联合阿德福韦酯胶囊治疗慢性乙型肝炎肝硬化的疗效显著,可改善患者肝功能、肝纤维化指标,提高HBV-DNA转阴率、HBeAg转阴率、HBeAg转换率,安全性较好,具有一定的临床推广应用价值.

目的:分析美沙拉嗪联合益生菌治疗炎性肠病临床疗效情况.方法:选择2016年9月—2019年9月来本院接受治疗的192例炎症性肠病患者为研究对象,按照就诊顺序分为两组,每组96例.对照组使用美沙拉嗪治疗,观察组在对照组基础上使用益生菌治疗,比较两组不良反应发生率、病理评分、疾病活动指数(DAI)分数及相关炎症指标.结果:观察组不良反应发生率(2.1％)低于对照组(29.9％),差异有统计学意义(P<0.05).干预后,观察组病理评分以及DAI分数改善情况明显好于对照组,差异有统计学意义(P<0.05).干预前,两组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及干扰素-γ水平(IFN-γ)指标无明显差别(P>0.05);干预后,观察组上述指标改善情况好于对照组,差异有统计学意义(P<0.05).结论:针对于炎症性肠病患者来讲,使用益生菌联合美沙拉嗪治疗疾病,安全性强、有效性高.

[Objective] To observe the effects of prokinetic agents combined with Chinese herbs on the delayed gastric emptying in diabetic rats and the underlying mechanism. [Methods] Totally 70 male SD rats were randomly divided into two groups:normal group (group A, n=10) and model group (n=60). The rats of model group was established as diabetes model by intraperitoneal injection of alloxan. The successful model rats were divided into four groups:control group (group B, n=15), Chinese herbs treatment group (group C, n=15), Itopride treatment group (group D, n=14), Itopride combined with Chinese herbs treatment group (group E, n=14). According to the requirements of each group, the corresponding drugs were given to the stomach every day. After 24 weeks of feeding, all rats were given 13C-gastric half-emptying time. Then all rats were killed. HE and nNOS immunohistochemical staining were used to observe the pathological changes of gastric wall. [Results] 1) Compared with the rats in group A, the gastric emptying time of all rats in model group (group B, C, D and E) were prolonged (P﹤0.01). 2) Compared with group B, the gastric emptying time in rats of group C, D and E were significantly reduced (P﹤0.05). Compared with Group D and C, they were significantly reduced in group E (P﹤0.01). 3) Compared with group A, the gastric smooth muscle cell in the model group became thinner, and the number of muscle plexus and the expression of nNOS in gastric smooth muscle of rats were significantly decreased in group B, C, D and E. 4) The number of muscle plexus in group B was significantly higher than that in group D, while the number in group group D was significantly lower than that in C and group E. Meanwhile, the number of nNOS positive nerve plexus in group D was significantly lower than that in group E. [Conclusion] Combined with Chinese herbs, prokinetic agents can promote the gastric emptying in diabetic rats effectively, and the effects are better than that of single use of Chinese herbs or prokinetic agents. The mechanism may correlated with its protective effects on smooth muscle and myenteric nerve plexus.

Objective:To observe the effect of Liqi Hewei Recipe on gastric emptying rate in diabetic gastroparesis rats associated with helicobacter pylori(HP) infection.Methods:The SD rats were randomly divided into four groups:control group,model group,itopride group,traditional Chinese medicine group.Each group was 15 samples(n=15).In addition to the normal group,applying alloxan(ALX) to induce diabetic rat model.And animals were inoculated orally HP strain(sydney strain 1).Evidence for HP infected was assessed by 13C-Urea Breath Test(UBT).Doing UBT again in 24 weeks after treatment and the residue rate of methyl orange was detected with the method of ultraviolet spectrophotometry,and the gastric emptying rate of the animals were measured.Results:The Liqi Hewei Recipe had a certain degree of inhibiting HP(P0.01),and the significant increase was obtained in the rate of gastric emptying(P0.01),and it was more effective than itopride(P0.01).Conclusion:Liqi Hewei Recipe has a certain degree of inhibiting HP and promotes the gastric empting rate.A certain correlation may exist between them.

<正>肠易激综合征(irritable bowel syndrom,IBS)是一组以腹痛、腹胀、排便习惯与性状改变为主要症状而又缺乏形态学和生化异常改变可以解释的征候群。世界范围内,IBS患病率为5%~25%,欧美发病率高于其他地区[1]。胃肠动力和内脏感觉异常

肺原性心脏病(肺心病)心力衰竭时心功能的改善对肺心病的预后有直接影响.我科采用丹红注射液对肺心病心力衰竭患者进行辅助治疗,疗效满意,现报告如下.

目的评价联合应用硝苯地平缓释片与依那普利片治疗高血压合并冠心病的疗效。方法将190例高血压合并冠心病患者分成治疗组95例,对照组95例。通过对比治疗观察其降压疗效及对心血管的影响。结果两组年龄、性别、血压、冠心病类型,均差异无显著性(P>0.05)。治疗组治疗8周后血压较对照组明显下降,治疗2年后缺血事件发生率较对照组下降(P<0.05)。结论两药合用治疗高血压合并冠心病降压疗效显著并能有效地降低心血管意外事件的发生率,不良反应发生率低。

<正>肠易激综合征(irritablebowelsyndrome,IBS)是一种原因不明的,以腹痛或腹部不适及大便习惯改变为特征的慢性功能性肠道病变。IBS是一种全消化道的运动功能障碍性疾病,并与肠道菌群失调有关。我们应用培菲康联合曲美布汀治疗IBS取得了满意的疗效。

<正>血管紧张素转换酶抑制剂(AngiotensinConver-tingEnzymeInhibitor,ACEI)问世以来发展非常迅速。ACEI最早作为扩血管降压药而开发,随着应用和研究的深入,其独立于降压作用之外的器官保护作用被发现和证实。JVCVⅡ中已把ACEI定为唯一拥有全部六个强适应证的药物。ACEI通过肾素-血管紧张素系统(RAS)和激肽释放酶-激肽系统

<正>我院自2003年2月开始采用胸腔留置中心静脉导管引流胸腔积液,此引流方法操作简单,创伤小,无痛苦,带管活动方便,引流效果满意。 一、材料和方法 经X射线或B超确诊大量胸腔积液患者,随机选择该术46例,男30例,女16例,年龄18~67

The ischemic cardiovasculer disease related to the atherosclerosis(AS) is the commonest complication of the patients with end stage renal disease(ESRD).The patients with ESRD have many risk factors related to the cardiovasculer disease.Some recent studies reveal the complex interaction between hyperhomocysteinemia,oxidative stress and microinflamnation may result in accelerated atherosclerosis in chronic renal failure(CRF).To investigate the relationship between various factors in patients with CRF,and its role in the pathogenesis of atherosclerosis in these patienes.It could provide new method of preventing and curing the ischemic cardiovasculer disease.