胃食管反流病与慢性胆囊炎相关性研究进展(1)
[摘要] 胃食管反流病和慢性胆囊炎是我国高发疾病，临床上见到较多的胃食管反流病重叠慢性胆囊炎的患者，是诊疗中的难点，目前国内外关于胃食管反流病和慢性胆囊炎相关性研究较少。查阅文献发现，胃食管反流病和慢性胆囊炎重叠患病率较高，有共同的危险因素，发病均与手术、迷走神经异常、Cajal间质细胞异常、胆汁反流密切相关，临床表现相似，有相同的治疗药物。胃食管反流病和慢性胆囊炎关系密切，本文就胃食管反流病和慢性胆囊炎的相关性做一综述，为进一步研究胃食管反流病重叠慢性胆囊炎提供依据，为临床诊疗提供参考。
[关键词] 胃食管反流病;相关性;慢性胆囊炎
[中图分类号] R571 [文献标识码] A [文章编号] 1673-7210(2020)10(c)-0041-04
Progress on the relationship between gastroesophageal reflux disease and chronic cholecystitis
XIAO Yun LI Yufang QIAO Dawei BU Ping
Department of Traditional Chinese Medicine， Medical College of Yangzhou University， Jiangsu Province， Yangzhou 225000， China
[Abstract] Gastroesophageal reflux disease and chronic cholecystitis are high incidence diseases in China. Patients with gastroesophageal reflux disease combined with chronic cholecystitis are very common clinically， which is the difficulty in diagnosis and treatment. At present， there are few studies on the correlation between gastroesophageal reflux disease and chronic cholecystitis at home and abroad. According to the literature review， the combined prevalence of gastroesophageal reflux disease and chronic cholecystitis is high， and there are common risk factors. Surgery， abnormal vagus nerve， abnormal interstitial cells of Cajal， and bile reflux are involved in the occurrence and development of gastroesophageal reflux disease and chronic cholecystitis. The clinical symptoms of gastroesophageal reflux disease and chronic cholecystitis are similar， and both diseases have the same therapeutic drugs. Gastroesophageal reflux disease is closely related to chronic cholecystitis. This article reviews the correlation between gastroesophageal reflux disease and chronic cholecystitis， in order to provide a basis for further research on gastroesophageal reflux disease combined with chronic cholecystitis， and provide a reference for clinical diagnosis and treatment.
[Key words] Gastroesophageal reflux disease; Correlation; Chronic cholecystitis
全球人群的研究報告中每周至少发生一次胃食管反流病(gastroesophageal reflux disease，GERD)症状的患者约为13%[1]，胆石症发病率也很高，为10%～15%[2]。临床工作中发现两病都有较高的发病率，并且症状易发生重叠，易出现误诊、漏诊等情况。同时发现大量胃食管反流病重叠慢性胆囊炎的患者，治疗效果不理想，常反复发病，危害患者的身体健康，造成医疗资源的浪费。胆石症、慢性胆囊炎与胃食管反流病这两类上消化道疾病之间是否有关联，胃食管反流病重叠慢性胆囊炎是否是独立的疾病，对避免误诊漏诊、及早准确地采取干预措施有重要意义，是临床工作者需要重视的问题。为此，本文查阅了大量文献，现报道如下：
1 重叠患病率
阿扎提江等[3]通过填写胃食管反流病调查问卷(GERD-Q)，前瞻性研究新疆维吾尔自治区人民医院的352例慢性胆囊炎患者与400例非慢性胆囊炎患者的GERD患病率，结果慢性胆囊炎组GERD患病率为27.8%，明显高于非慢性胆囊炎组的17.0%。徐丽苹[4]通过反流性疾病问卷调查、胃镜及24 h食管多通道腔内阻抗-pH监测研究慢性胆囊炎组及健康对照组患者各300例，发现慢性胆囊炎组GERD发生率为29.3%，明显高于健康对照组的3.0%。Dzhulai等[5]报道胆囊炎患有难治性GERD的风险是健康对照组的6.776(1.917～23.956)倍。以上研究均提示GERD与慢性胆囊炎关系密切，重叠患病率较高。, 百拇医药(肖云 李玉芳 乔大伟 卜平)
[关键词] 胃食管反流病;相关性;慢性胆囊炎
[中图分类号] R571 [文献标识码] A [文章编号] 1673-7210(2020)10(c)-0041-04
Progress on the relationship between gastroesophageal reflux disease and chronic cholecystitis
XIAO Yun LI Yufang QIAO Dawei BU Ping
Department of Traditional Chinese Medicine， Medical College of Yangzhou University， Jiangsu Province， Yangzhou 225000， China
[Abstract] Gastroesophageal reflux disease and chronic cholecystitis are high incidence diseases in China. Patients with gastroesophageal reflux disease combined with chronic cholecystitis are very common clinically， which is the difficulty in diagnosis and treatment. At present， there are few studies on the correlation between gastroesophageal reflux disease and chronic cholecystitis at home and abroad. According to the literature review， the combined prevalence of gastroesophageal reflux disease and chronic cholecystitis is high， and there are common risk factors. Surgery， abnormal vagus nerve， abnormal interstitial cells of Cajal， and bile reflux are involved in the occurrence and development of gastroesophageal reflux disease and chronic cholecystitis. The clinical symptoms of gastroesophageal reflux disease and chronic cholecystitis are similar， and both diseases have the same therapeutic drugs. Gastroesophageal reflux disease is closely related to chronic cholecystitis. This article reviews the correlation between gastroesophageal reflux disease and chronic cholecystitis， in order to provide a basis for further research on gastroesophageal reflux disease combined with chronic cholecystitis， and provide a reference for clinical diagnosis and treatment.
[Key words] Gastroesophageal reflux disease; Correlation; Chronic cholecystitis
全球人群的研究報告中每周至少发生一次胃食管反流病(gastroesophageal reflux disease，GERD)症状的患者约为13%[1]，胆石症发病率也很高，为10%～15%[2]。临床工作中发现两病都有较高的发病率，并且症状易发生重叠，易出现误诊、漏诊等情况。同时发现大量胃食管反流病重叠慢性胆囊炎的患者，治疗效果不理想，常反复发病，危害患者的身体健康，造成医疗资源的浪费。胆石症、慢性胆囊炎与胃食管反流病这两类上消化道疾病之间是否有关联，胃食管反流病重叠慢性胆囊炎是否是独立的疾病，对避免误诊漏诊、及早准确地采取干预措施有重要意义，是临床工作者需要重视的问题。为此，本文查阅了大量文献，现报道如下：
1 重叠患病率
阿扎提江等[3]通过填写胃食管反流病调查问卷(GERD-Q)，前瞻性研究新疆维吾尔自治区人民医院的352例慢性胆囊炎患者与400例非慢性胆囊炎患者的GERD患病率，结果慢性胆囊炎组GERD患病率为27.8%，明显高于非慢性胆囊炎组的17.0%。徐丽苹[4]通过反流性疾病问卷调查、胃镜及24 h食管多通道腔内阻抗-pH监测研究慢性胆囊炎组及健康对照组患者各300例，发现慢性胆囊炎组GERD发生率为29.3%，明显高于健康对照组的3.0%。Dzhulai等[5]报道胆囊炎患有难治性GERD的风险是健康对照组的6.776(1.917～23.956)倍。以上研究均提示GERD与慢性胆囊炎关系密切，重叠患病率较高。, 百拇医药(肖云 李玉芳 乔大伟 卜平)