The Clinical Characteristics And Treatment Of Non-erosive Reflux Disease

Investigation of Symptom Spectrum and Possible Relative Factors in Patients with Non-erosive Reflux Disease and Reflux EsophagitisAims:To investigate thedemographics, symptom spectrum, diet, quality of life and psychological statusin patients with NERDand RE and compare the clinical characteristics between the two groups for the further study of the pathogenesis and effective treatment of GERD.Subjects and Methods:95 cases of GERD patients were enrolled in the study,including 50 cases of NERD patients (18 males,32 females, mean age 44.1±13.4 years),45 cases of RE patients (22 males,23 females, mean age 46.5±9.9 years). To analyse the demographics, clinical features, diet and lifestyle, quality of life, psychologicalstatus in patients with NERDand RE by questionnaires.Results:(1) The regurgitation symptom score and the rate of regurgitationsymptoms in NERDgroupwere lower than RE group[0 (0,2) vs.2.0 (0,3.0), P<0.05; 45.0% vs.64.4%, P<0.05]. Reflux symptom score had no significant difference between two groups[8.0 (6.0,11.0) vs.10.0 (7.0,13.0), P>0.05].(2) The top fivediet causing reflux symptoms were:milk, spicy food, onion or ginger,chocolateand yogurt. The top fivefactors causing reflux symptomsbesides diet were:bad mood, eating too fast, cold, less movement and poor sleep. (3) NERD patients withpsychological abnormality had significantly higherreflux symptom score than those with no psychological abnormality(10.9±4.7 vs. 8.3±2.8, P<0.05).(4) Anxiety and depression score was correlated with reflux symptom score in NERD(r=0.42, P<0.01; r=0.29, P<0.05), and reflux symptom score was significantly correlated with GERD-HRQL (r=0.49, P<0.01).Conclusions:The proportion of women was higher and regurgitationsymptom was less serious in NERD groupthan RE group, but reflux symptom score had no significant difference between the two groups. Diet andlifestyle played a certain role in the occurrence of NERD symptoms. Reflux symptoms were significantly correlated with quality of life and psychological status in NERD patients.Evaluation of Esophageal Function in NERDby Multichannel Intraluminal Impedance-pH Monitoring Combined with Acid Perfusion Test and NERD patients quality of life of observation and evaluationAims:By 24 h esophageal multi-channel cavity impedance - pH (MⅡ - pH) monitoring and acid perfusion experimental study on the non erosive reflux disease (NERD) patients We find esophageal impedance dynamic change. At the same time through the SF - 36 scale we can evaluation the life quality of patientSubjects and Methods:From September 2014 to July 2015, a total of 45 NERD patients from Hospital and 30 healthy controls were subjected to 24 h MII-pH monitoring,acid perfusion and SF-36 scale.Results:(1) In NERD patients groups:the deMeester score of 6.7 (3.610.1), the acid reflux number 27.8 (13.943.2),non- acid reflux number 26.8 (18.0 42.6)weresignificantly higher than that of healthy controls (1.4 (0.2 3.2),0.4 (0.2 0.7)%, 5.0 (2.2 10.7),5.7 (3.6 9.1), P< 0.01). (2)NERD patients had lower impedance baseline of distal esophagus (2996±701 Ω vs.3870±1054 Ω, P<0.01).lower impedance recovery rate after acid perfusion (30.6 ± 14.0 Ω/min vs.52.0±14.5 Ω/min, P<0.01).(3)The NERD patients with positive response in acid perfusion test showed lower baseline impedance (2758±660 Ω vs.3410±536 Ω, P< 0.01) and lower impedance recovery rate (24.9±13.3 Ω/min vs.33.7±10.3 Ω/min, P<0.05) than those felt no pain during perfusion.(4)There were significant reduction in all scales and summaries for group patients compared to healthy controls.Conclusions:(1)The NERD patients have more obvious abnormal esophageal dynamics. (2). The NERD in the assessment of quality of life in patients with impaired mental health is more noticeable, (3)We should pay attention to the treatment of patients with psychological support.The specificof treatment for the non erosive reflux DiseaseAims:By comparing the specificity of the therapeutic effect of the treatment of erosive reflux disease.In the future,it may become the guide of treatment for NERD.Subjects and Methods:From January 2014 and December 2015, in several hospitals outpatient of 48 patients with erosivereflux Disease. All the NERD patients were admitted into the observation, in the form of question in patients with sex, age, height, body quality, duration, family history. RDQ record patients’clinical symptoms, HAM-A^ HAM-D records in patients with anxiety depression. Esophageal dynamic monitoring and 24 h MⅡ-pH monitoring. They were randomly divided into specific treatment group 24 cases in treatment group and experience.Results:(1)In the specific treatment group, the abnormal of Esophageal motility is 10 cases (41.7%), abnormal psychological spirit is 14 cases (58.3%). Experience in the treatment group, the abnormal of Esophageal motility is11 cases (45.7%), abnormal psychological mental abnormality is 13 (54.3%). (2) two groups of patients before treatment RDQ symptoms was no statistically significant difference (P> 0.05); Degree of two groups after treatment in patients with clinical symptoms total score was significantly lower than group before the treatment, and specific treatment group is lower than the control group, the difference had statistical significance (P< 0.05). (3)Two groups of patients before treatment of anxiety and depression scores, there was no statistically significant difference; In the two groups after treatment of anxiety and depression scores were lower than group before the treatment, and specific treatment group is lower than the control group, the difference had statistical significance (P< 0.05).Conclusions:In the treatment of NERD, specificity of treatment can enhance curative effect, effectively relieve the clinical symptoms of the disease.It can increase the body’s tolerance patients.The specificity of treatment is worthy of clinical popularization and application.