Centre for Gastroenterological Research and Division of Gastroenterology, University Hospital Gasthuisberg, Catholic University Leuven, Belgium.
Aliment Pharmacol Ther. 2012 Jun;35(11):1257-66. doi: 10.1111/j.1365-2036.2012.05086.x. Epub 2012 Apr 8.
About one-third of patients with gastro-oesophageal reflux disease (GERD) have frequent and/or severe reflux symptoms ('disruptive GERD'). The relative burden of disruptive GERD on health-related quality of life (HRQL) has not been systematically investigated.
To assess the burden of disruptive vs. nondisruptive GERD on HRQL.
Systematic searches were conducted in PubMed and Embase. To be included, studies had to have used validated questionnaires to assess HRQL.
Nineteen studies were included. Data on the comparative burden of frequent (ranging from daily to ≥weekly) and severe reflux symptoms were provided in eight and 13 studies respectively; six reported on the additional burden of nocturnal symptoms. Compared with individuals with nondisruptive GERD, those with disruptive GERD had 2.4-times and 1.5-times higher mean rates of absenteeism and presenteeism respectively (five studies), 1.5-times lower sleep quality scores (three studies), 1.1-times lower mean summary scores for physical and mental health (five studies) and 1.3-times lower mean scores for psychological and general well-being (four studies). Increasing symptom frequency and severity both increased the burden of disease to a similar extent. The presence of nocturnal symptoms in addition to daytime symptoms led to worsening of physical health, but their effect on mental health and work productivity was less clear.
Disruptive GERD is associated with a high burden of disease compared with occasional or mild reflux symptoms. Disease management needs to vary across the GERD spectrum and should be tailored to patients' requirements for optimal therapeutic outcomes.
约三分之一的胃食管反流病（GERD）患者存在频繁和/或严重的反流症状（“破坏性 GERD”）。破坏性 GERD 对健康相关生活质量（HRQL）的相对负担尚未系统研究。
评估破坏性与非破坏性 GERD 对 HRQL 的负担。
系统检索了 PubMed 和 Embase。纳入的研究必须使用经过验证的问卷来评估 HRQL。
纳入了 19 项研究。有 8 项研究提供了关于频繁（每天至每周≥一次）和严重反流症状的比较负担数据，13 项研究报告了夜间症状的额外负担。与非破坏性 GERD 患者相比，破坏性 GERD 患者的缺勤率分别高出 2.4 倍和 1.5 倍（5 项研究），睡眠质量评分低 1.5 倍（3 项研究），身体和心理健康综合评分低 1.1 倍（5 项研究），心理和一般健康状况评分低 1.3 倍（4 项研究）。症状频率和严重程度的增加都会导致疾病负担的增加。除日间症状外，夜间症状的存在会导致身体健康恶化，但对心理健康和工作效率的影响不太明确。
与偶尔或轻度反流症状相比，破坏性 GERD 与更高的疾病负担相关。疾病管理需要根据 GERD 谱的不同而有所变化，并应根据患者的需求进行调整，以获得最佳的治疗效果。
