Omeprazole And Ranitidine Treatment Of The Elderly Hiatal Hernia Reflux Esophagitis Evaluation

ObjectiveTo separate the use of Omeprazole and Ranitidine treatment of the elderly hiatal hernia reflux esophagitis, and to observe it's effect.MethodsFrom September 2007 to October 2008, Gstroenterology dept of Taian city 88 hospital out-patient and 80 patients endoscopic and X-ray examination,who are proved to have hiatal hernia and reflux esophagitis. patients 80 to random number table will be randomly divided into two groups of patients, the treatment group 40 cases, 40 cases of the control group. 80 cases of endoscopy, in the light of the Savary-Miller grading esophageal endoscopy, the treatment group 15 cases of gradeâ…¡,â…¢grade seven cases, the control group 18 cases of gradeâ…¡,â…¢grade in 6 cases. X-ray examination, sliding hiatal hernia in 61 cases (accounting for 76.25%), five cases of esophageal hiatal hernia side (6.25%), mixed type hernia in 14 cases (17.5%). Oral treatment group, omeprazole 20mg, daily 2 times, taking half an hour before dinner; control group oral ranitidine 150mg, 2 times / day, were treated for 8 weeks. Endoscopic review every eight weeks, patients recorded symptoms every week. All patients in the selected time and treatment were carried out after the end of the blood, urine, feces, liver and kidney function, blood glucose, blood lipids and ECG tests and other conventional indicators; the light reflux disease questionnaire (refluxdiagnostic questionnaire, RDQ), recorded before and after treatment in patients with heartburn , reflux, non-cardiac chest pain, acid reflux symptoms and the severity of the attack frequency points for evaluation of clinical symptoms; recorded before and after treatment in patients with gastroscopy results of endoscopic evaluation of classification and points in drug after 16 weeks of follow-up to observe changes in their symptoms, recurrence of the situation of evaluation.Results(1)The number of participants in analysis: the use of telephone follow-up method, etc., 80 patients entered the final analysis.(2) The difference between the two groups of patients compared to general information: two groups of patients with gender, age, course of disease, an analysis of pre-treatment condition, results of comparable groups of patients (P>0.05).(3) Before and after treatment the degree of endoscopic esophagitis compared: the treatment group and control group were significantly different (P<0.01).(4) Before and after endoscopic treatment effects: treatment group 40 cases, 20 cases of cure (50.00%), effective in 12 cases (30.00%), 2 cases (5.00%), total effective rate was 95.00 percent: the control group 40 cases of cure in 14 cases (35.0%), effective 11 cases (27.5%), nine cases of invalid (22.5%), total effective rate of 77.5%. After treatment in patients with gastroscopy under the effect of the two groups compared by the X2 test, the difference between the total effective rate (p<0.05), treatment group was significantly higher than the total effective rate; cure rate is no difference (P>0.05).(5) Comparison of clinical efficacy after treatment: 40 cases of treatment group, 25 cases of clinically cured, 11 cases markedly effective in 2 cases, 2 cases ineffective, the total effective rate 95.00%; 40 cases of the control group, 26 cases of clinical cure, effective 10 cases, six cases of effective and ineffective in 8 cases, total effective rate of 80.00%. By the X² test, the two groups after treatment the total effective rate of comparison, the difference was significant (P<0.05).(6) Relapse compared to the situation in the two groups: drug treatment group after 16 weeks of follow-up of 35 cases, eight cases of patients with recurrence, the recurrence rate was 22.86%; control group, 30 patients with follow-up, 17 cases of recurrence, the recurrence rate was 56.67%. By the X2 test, the difference was significant (P<0.01).(7)The safety of observation: the two groups were not significant in patients with adverse reactions, patients are able to tolerate, two test cases were completed, no cases of serious adverse reactions due to the interruption of treatment. Through the blood before and after treatment, urine routine, stool routine, liver and kidney function, blood glucose, blood lipids and ECG results showed that, the examinations are normal, no abnormal changes were found.ConclusionH₂ receptor antagonists acid inhibitors inadequate capacity, omeprazole can inhibit the cell wall of the H⁺/K⁺-ATP-blocking the final link in gastric acid secretion, and bioavailability as the duplication of administration and increase, which also decided Omeprazole a strong and lasting effects of acid inhibitors, to improve the pH value of LES to neutral, in a short period of time on the Elimination of gastric acid erosion and to maintain the acid-free status, which is conducive to healing inflammation and ulcers.