反流性食管炎患者的症状缓解：奥美拉唑、兰索拉唑和雷贝拉唑的对比研究。
Symptom relief in patients with reflux esophagitis: comparative study of omeprazole, lansoprazole, and rabeprazole.
作者信息
Adachi Kyoichi, Hashimoto Tomoyuki, Hamamoto Naoharu, Hirakawa Kazuya, Niigaki Masatoshi, Miyake Tatsuya, Taniura Hiroyuki, Ono Masahiro, Kaji Takekazu, Suetsugu Hiroshi, Yagi Junko, Komazawa Yoshinori, Mihara Takafumi, Katsube Tomoko, Fujishiro Hirofumi, Shizuku Toshihiro, Hattori Shuzo, Yamamoto Shun, Kinoshita Yoshikazu
机构信息
Department of Internal Medicine II, Shimane Medical University, Department of Internal Medicine, Unnan General Hospital, Shimane, Japan.
出版信息
J Gastroenterol Hepatol. 2003 Dec;18(12):1392-8. doi: 10.1046/j.1440-1746.2003.03190.x.
BACKGROUND AND AIM
Rabeprazole has a faster onset of antisecretory activity than omeprazole and lansoprazole. The aim of the present study was to clarify whether there is any difference in the speed of symptom relief in patients with reflux esophagitis following the administration of these three proton pump inhibitors (PPI).
METHODS
Eighty-five patients with erosive reflux esophagitis were randomized to receive 8 weeks of 20 mg of omeprazole (n = 30), 30 mg of lansoprazole (n = 25), or 20 mg of rabeprazole (n = 30) once a morning. Daily changes in heartburn and acid reflux symptoms in the first 7 days of administration were assessed using a six-point scale (0: none, 1: mild, 2: mild-moderate, 3: moderate, 4: moderate-severe, 5: severe).
RESULTS
The mean heartburn score in patients administered rabeprazole decreased more rapidly than those given the other PPI. Complete heartburn remission also occurred more rapidly in patients administered rabeprazole (compared with omeprazole: P = 0.035, compared with lansoprazole: P = 0.038 by log-rank test). No differences were seen in the rate of endoscopic healing of reflux esophagitis at 8 weeks between the three treatment regimens.
CONCLUSION
Rabeprazole may be more effective than omeprazole and lansoprazole for the rapid relief of heartburn symptoms in patients with reflux esophagitis.
背景与目的
雷贝拉唑的抗分泌活性起效速度比奥美拉唑和兰索拉唑更快。本研究的目的是明确在反流性食管炎患者中，给予这三种质子泵抑制剂（PPI）后症状缓解速度是否存在差异。
方法
85例糜烂性反流性食管炎患者被随机分为三组，分别接受为期8周的每日一次晨起口服20mg奥美拉唑（n = 30）、30mg兰索拉唑（n = 25）或20mg雷贝拉唑（n = 30）治疗。使用六点量表（0：无，1：轻度，2：轻度 - 中度，3：中度，4：中度 - 重度，5：重度）评估给药后前7天烧心和反酸症状的每日变化。
结果
服用雷贝拉唑患者的平均烧心评分下降速度比服用其他PPI的患者更快。服用雷贝拉唑的患者烧心症状完全缓解也更快（与奥美拉唑相比：通过对数秩检验，P = 0.035；与兰索拉唑相比：P = 0.038）。三种治疗方案在8周时反流性食管炎的内镜愈合率无差异。
结论
在反流性食管炎患者中，雷贝拉唑在快速缓解烧心症状方面可能比奥美拉唑和兰索拉唑更有效。
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