Kinoshita Yoshikazu, Ashida Kiyoshi, Miwa Hiroto, Hongo Michio
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Shimane, Japan.
Am J Gastroenterol. 2009 May;104(5):1106-11. doi: 10.1038/ajg.2009.77. Epub 2009 Mar 31.
Although lifestyle modification involving diet, exercise, cessation of smoking, etc. is generally advised for patients with reflux esophagitis (RE), few data that show its clinical benefits are available. We analyzed whether lifestyle modification improves health-related quality of life (HRQOL) in Japanese patients with RE receiving the proton pump inhibitor (PPI) lansoprazole as a post hoc analysis of an observational study that investigated the effect of lansoprazole on HRQOL.
Patients with RE received lansoprazole for 8 weeks. HRQOL was assessed using the 8-Item Short-Form Health Survey (SF-8) and RE-specific HRQOL questionnaires at baseline and after 4 and 8 weeks of treatment. Physical and mental component summaries (PCS, MCS) and RE-specific summary (RES) scores were calculated.
Of the 8,757 patients analyzed, 40.8% were advised regarding new lifestyle at the start of lansoprazole treatment (Group A), 33.3% were advised to continue the lifestyle as advised previously (Group B), and 25.9% did not receive any advice (Group C). The change in PCS from baseline at week 8 for Group A was 5.7 +/- 8.1, and this was significantly greater (P < 0.001) than the increases achieved in Groups B (4.3 +/- 7.5) and C (4.0 +/- 7.6). The changes in MCS and RES were also significantly greater in Group A than in the other groups. The changes in HRQOL scores from baseline were significantly greater in Group A than in the other groups, irrespective of baseline patient characteristics.
Lifestyle modification may be clinically beneficial in terms of improving HRQOL in Japanese patients with RE who are receiving treatment with a PPI.
虽然一般建议反流性食管炎（RE）患者进行饮食、运动、戒烟等生活方式的改变，但几乎没有数据显示其临床益处。我们对一项观察性研究进行事后分析，该研究调查了兰索拉唑对健康相关生活质量（HRQOL）的影响，分析生活方式的改变是否能改善接受质子泵抑制剂（PPI）兰索拉唑治疗的日本RE患者的HRQOL。
RE患者接受兰索拉唑治疗8周。在基线以及治疗4周和8周后，使用8项简短健康调查（SF - 8）和RE特异性HRQOL问卷评估HRQOL。计算身体和心理成分总结（PCS、MCS）以及RE特异性总结（RES）得分。
在分析的8757例患者中，40.8%在兰索拉唑治疗开始时接受了新的生活方式建议（A组），33.3%被建议继续之前建议的生活方式（B组），25.9%未接受任何建议（C组）。A组第8周时PCS相对于基线的变化为5.7±8.1，显著大于B组（4.3±7.5）和C组（4.0±7.6）的增加幅度（P < 0.001）。A组MCS和RES的变化也显著大于其他组。无论患者基线特征如何，A组HRQOL得分相对于基线的变化均显著大于其他组。
对于接受PPI治疗的日本RE患者，生活方式的改变在改善HRQOL方面可能具有临床益处。
