CURE Digestive Diseases Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
Dig Dis Sci. 2010 May;55(5):1325-36. doi: 10.1007/s10620-009-0871-8. Epub 2009 Jul 7.
Gastroesophageal reflux disease (GERD) is a chronic symptomatic condition and may be associated with erosive esophagitis (EE). Considerable data on the long-term maintenance of healing of EE are available, but data on long-term GERD symptom prevention and patient quality of life (QOL) are limited.
To investigate QOL in subjects with healed EE who received 12 months of double-blind maintenance treatment with lansoprazole or ranitidine, followed by long-term open-label lansoprazole therapy to prevent recurrence of EE.
Subjects with healed EE received 12 months of double-blind maintenance treatment with lansoprazole 15 mg once daily or ranitidine 150 mg twice daily, followed by dose-titrated, open-label lansoprazole therapy for up to 82 months.
During double-blind treatment (n = 206), lansoprazole-treated patients showed significantly (P <or= 0.05) greater improvements than ranitidine-treated patients in the frequency, severity, and 'bothersomeness' of heartburn, the symptom index, problems of activity limitation, eating and drinking problems, symptom problems, health distress, and social functioning. During dose-titrated, open-label treatment (n = 195), all disease-specific QOL scales except sleep improved significantly (P < 0.001) from open-label baseline at each time-point.
Maintenance treatment with lansoprazole for 12 months in healed EE subjects produced significantly greater improvements in QOL indicators than ranitidine. These improvements were sustained during dose-titrated, open-label lansoprazole treatment.
胃食管反流病(GERD)是一种慢性症状性疾病,可能与糜烂性食管炎(EE)有关。目前已有大量关于 EE 愈合后长期维持治疗的数据,但关于长期 GERD 症状预防和患者生活质量(QOL)的数据有限。
调查接受 12 个月兰索拉唑或雷尼替丁双盲维持治疗后 EE 愈合的患者的 QOL,随后进行长期开放标签兰索拉唑治疗以预防 EE 复发。
EE 愈合的患者接受 12 个月的兰索拉唑 15mg 每日一次或雷尼替丁 150mg 每日两次的双盲维持治疗,随后进行剂量滴定的开放标签兰索拉唑治疗,最长可达 82 个月。
在双盲治疗期间(n=206),与雷尼替丁组相比,兰索拉唑组患者的烧心频率、严重程度和“困扰度”、症状指数、活动受限问题、饮食和饮水问题、症状问题、健康困扰和社会功能等方面的改善均具有显著意义(P<0.05)。在剂量滴定的开放标签治疗期间(n=195),除睡眠外,所有疾病特异性 QOL 量表均在每个时间点均从开放标签基线显著改善(P<0.001)。
在 EE 愈合患者中,兰索拉唑治疗 12 个月可显著改善 QOL 指标,优于雷尼替丁。这些改善在剂量滴定的开放标签兰索拉唑治疗期间得以维持。