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胃食管反流病致病因素繁多,发病机制复杂,烧心和反流为最常见典型症状;PPI试验简单、有效、敏感度较高,可作为GERD初步诊断方法,但特异度不高;具有反流症状的初诊患者建议内镜检查;食管钡餐造影、食管测压等亦可协助诊疗。西医治疗以缓解症状(抑制胃酸分泌、质子泵抑制剂(PPI)是首选药物,PPI治疗效果不佳时,可联合促动力药物),提高生活质量,预防并发症为主。LES注射、电刺激、呼吸肌训练法及膈肌生物反馈训练(diaphragm biofeedback training DBT)等新型治疗方法随着科技进步而兴起。中医药以辨证为基础,针灸、电针、耳针、穴位按摩、穴位注射等,操作简便,疗效好;联合西医治疗,疗效显著。随着科学的进步,分子生物学,精神心理学,遗传学等多学科的介入,新型诊疗技术的层出不穷,对于胃食管反流病的诊疗正逐得到完善。
Gastroesophageal reflux disease has many pathogenic factors, complicated pathogenesis, heartburn and reflux are the most common typical symptoms; PPI test is simple, effective, sensitive and can be used as a primary diagnostic method for GERD, but the specificity is not high; Flow symptoms of newly diagnosed patients recommended endoscopy; esophageal barium meal angiography, esophageal manometry can also help diagnosis and treatment. Western medicine to relieve symptoms (inhibition of gastric acid secretion, proton pump inhibitor (PPI) is the drug of choice, PPI treatment ineffective, the combination of motivation drugs), improve quality of life, the main prevention of complications. LES injection, electrical stimulation, respiratory muscle training and diaphragm biofeedback training (DBT) and other new treatment methods with the rise of science and technology. TCM based on syndrome differentiation, acupuncture, electroacupuncture, acupuncture, acupressure, acupoint injection, easy to operate, good effect; combined with Western medicine, the effect is significant. With the progress of science, molecular biology, psychology, genetics and other multidisciplinary intervention, an endless stream of new diagnosis and treatment technology, diagnosis and treatment of gastroesophageal reflux disease is gradually improved.