【摘要】 目的探索提高肿瘤患者所患难治性胃食管反流病(GERD)及其反流性食管炎(RE)治疗效果的措施。方法回顾性分析2008年2月至2010年7月,盐城市肿瘤医院按GERD共识意见和RE指南中多种药物治疗8周以上无效且伴有难治性GERD及合并RE的14例肿瘤患者,在继续服用或改服质子泵抑制剂雷贝拉唑,H2受体拮抗剂雷尼替丁或法莫替丁、胃动力剂莫沙必利,同时继续服用抗生素克拉霉素缓释片、庆大霉素注射液基础上,加服选择性环氧化酶-2(COX-2)抑制剂塞来昔布200~400 mg,每天2次,连服14 d观察近期疗效。结果 14例(100%)患者均于3~7 d内嗳气、反酸、胃灼热、胸骨后或剑突下灼痛,夜间不能平卧等症状锐减,食欲随之改善;其中12例(85.71%)于7~10 d内上述症状消失,2例疗程未满14 d即出院;2例症状复发。结论 GERD和RE的发生、发展及其程度与COX-2的高表达呈正相关已为多项研究所证实,故对肿瘤患者合并难治性GERD、RE,在常规药物治疗基础上加用选择性COX-2抑制剂塞来昔布可提高其疗效。更多还原

【Abstract】 Objective To explore new therapy for tumor patients of who had got gastroesophageal reflux disease(GERD) and reflux esophagitis(RE).Methods Fourteen hospitalized cancer patients of who had got refractory GERD and combined with RE,were enrolled in this study.All the patients were invalid to a variety of drug treatment for more than 8 weeks.All of them had taken several kinds of drugs before this study,including omeprazole or rabeprazole、ranitidine or famotidine、mosapride.Adding selective cyclooxygenase-2(cyclo-oxygen-ase 2) inhibitors celecoxib used with 200 or 400 mg bid,and taking gentamicin、clarithromycin sustained-release tablets at the same time for 14 days.Results Symptoms were improved:all of the 14(100%) patients got better in 3 ~ 7 days.The symptoms such as belching,acid reflux," heartburn " feeling,sternum or sword burning,loss of appetite,and no supine at night were significantly improved.Disappeared Symptom:12(85.71%) of them got completely relieved while the other two discharged from hospital in less than 14 days.Symptom relapsed:two(14.29%).Conclusion Mach researches have confirmed GERD and RE occurrence,development and its degree was positively correlated with high expression of COX-2,therefore,adding COX-2 inhibitor-Celecoxib on the basic therepy schedule could enhance the therepy effect of refractory GERD and RE among cancer patients.更多还原