Uemura Naomi, Inokuchi Hideto, Serizawa Hiroshi, Chikama Toshiharu, Yamauchi Masao, Tsuru Tomomi, Umezu Toru, Urata Toshiro, Yurino Nobuo, Tanabe Satoshi, Yoshida Tomoharu, Kawamura Susumu, Murakami Atsushi, Yamamoto Munemitsu, Chiba Tsutomu
Department of Gastroenterology, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-0052, Japan.
J Gastroenterol. 2008;43(9):670-8. doi: 10.1007/s00535-008-2214-5. Epub 2008 Sep 20.
There is increasing awareness of nonerosive reflux disease (NERD) as a disease requiring treatment in Japan. This randomized, double-blind, placebo-controlled, parallel-group study was conducted to investigate the efficacy and safety of omeprazole 10 mg and 20 mg once daily in Japanese patients with NERD.
Patients with heartburn for at least 2 days a week during the month before entry into the study and no endoscopic signs of a mucosal break (grade M or N according to Hoshihara's modification of the Los Angeles classification) were randomly assigned to one of three groups (omeprazole 10 mg or 20 mg, or placebo) once daily for 4 weeks.
Overall, 355 patients were enrolled, of whom 284 were randomly assigned to one of the three groups (omeprazole 10 mg, n = 96; omeprazole 20 mg, n = 93; placebo, n = 95). The rate of complete resolution of heartburn in week 4 was significantly higher in patients treated with omeprazole 10 mg [32.3%, 95% confidence interval (CI), 22.9%-41.6%] or 20 mg (25.8%, 95% CI, 16.9%-34.7%) than in the placebo group (12.0%, 95% CI, 5.3%-18.6%). No significant difference between the two omeprazole groups was observed. The rate of complete resolution of heartburn by omeprazole was similar between patients with grade M and those with grade N esophagus. Omeprazole also increased the rate of sufficient relief from heartburn. Omeprazole was well tolerated.
Omeprazole 10 mg or 20 mg once daily is effective and well tolerated in patients with NERD regardless of their endoscopic classification.
在日本,非糜烂性反流病(NERD)作为一种需要治疗的疾病,人们对其的认识日益增加。本随机、双盲、安慰剂对照、平行组研究旨在调查每日一次服用10毫克和20毫克奥美拉唑对日本NERD患者的疗效和安全性。
在进入研究前一个月内每周至少有2天出现烧心症状且无黏膜破损内镜表现(根据星原对洛杉矶分类法的修改为M级或N级)的患者被随机分配到三个组之一(10毫克或20毫克奥美拉唑组,或安慰剂组),每日一次,共4周。
总体上,355例患者入组,其中284例被随机分配到三个组之一(10毫克奥美拉唑组,n = 96;20毫克奥美拉唑组,n = 93;安慰剂组,n = 95)。在第4周时,服用10毫克奥美拉唑(32.3%,95%置信区间[CI],22.9%-41.6%)或20毫克奥美拉唑(25.8%,95%CI,16.9%-34.7%)的患者烧心完全缓解率显著高于安慰剂组(12.0%,95%CI,5.3%-18.6%)。两个奥美拉唑组之间未观察到显著差异。M级和N级食管患者中,奥美拉唑导致烧心完全缓解的比例相似。奥美拉唑还提高了烧心充分缓解的比例。奥美拉唑耐受性良好。
无论内镜分类如何,每日一次服用10毫克或20毫克奥美拉唑对NERD患者有效且耐受性良好。