综述文章:胃食管反流病——完全缓解概念的应用
Review article: Gastro-oesophageal reflux disease--application of the concept of complete remission.
作者信息
Oudkerk Pool M
机构信息
Department of Gastroenterology, Isala Clinics, Zwolle, The Netherlands.
出版信息
Aliment Pharmacol Ther. 2007 Dec;26 Suppl 2:13-6. doi: 10.1111/j.1365-2036.2007.03493.x.
BACKGROUND
Therapeutic success in the treatment of gastro-oesophageal reflux disease cannot be measured by endoscopic healing or symptomatic relief alone. Assessment of treatment efficacy should be based on symptomatic relief and endoscopic healing. As most questionnaires focus on heartburn, it is important to stress that there is more to gastro-oesophageal reflux disease than just heartburn. The 'complete remission' concept was recently introduced; an approach in which endoscopic appearances and symptomatic relief are integrated, thus allowing the full gastro-oesophageal reflux disease picture and its changes over time to be described in a simple and accurate manner. Complete remission is defined as the absence of both oesophagitis and symptoms. ReQuest, a relatively new questionnaire acceptable as a clinical endpoint in trials, seems to be of use in daily practice.
AIM
To review the utility of the ReQuest questionnaire.
RESULTS
This questionnaire assesses the gastro-oesophageal reflux disease symptom profile using 67 symptom descriptions adapted from patients' view, doctors' view, clinical trials and from the literature. Individual symptoms are reduced to seven dimensions by factor analysis and expert consensus. This gives insight into multiple symptoms over time as well as individual patient profiles. ReQuest determines symptom relief using a gastro-oesophageal reflux disease symptom threshold. This unique concept allows the doctor to measure the time to first symptom relief and also to sustained symptom relief.
CONCLUSIONS
ReQuest makes it possible to evaluate the complete symptom spectrum in patients with non-erosive oesophageal reflux disease and gastro-oesophageal reflux disease. ReQuest is available for daily practice to use for comparability with regard to treatment efficacy.
背景
胃食管反流病的治疗成功不能仅通过内镜愈合或症状缓解来衡量。治疗效果的评估应基于症状缓解和内镜愈合。由于大多数问卷都聚焦于烧心,必须强调的是,胃食管反流病不仅仅只有烧心症状。最近引入了“完全缓解”的概念;这种方法将内镜表现和症状缓解结合起来,从而能够以简单准确的方式描述胃食管反流病的全貌及其随时间的变化。完全缓解定义为食管炎和症状均不存在。ReQuest是一种相对较新的问卷,可作为试验中的临床终点,似乎在日常实践中有用。
目的
回顾ReQuest问卷的实用性。
结果
该问卷从患者视角、医生视角、临床试验及文献中选取了67种症状描述来评估胃食管反流病的症状概况。通过因子分析和专家共识,将个体症状归纳为七个维度。这有助于了解一段时间内的多种症状以及个体患者的情况。ReQuest使用胃食管反流病症状阈值来确定症状缓解情况。这一独特概念使医生能够测量首次症状缓解的时间以及持续症状缓解的时间。
结论
ReQuest能够评估非糜烂性食管反流病和胃食管反流病患者的完整症状谱。ReQuest可用于日常实践,以便在治疗效果方面进行比较。