Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Hamra 11032090, Beirut, Lebanon.
World J Gastroenterol. 2012 May 21;18(19):2390-5. doi: 10.3748/wjg.v18.i19.2390.
To compare the efficacy of the proton-pump inhibitor, rabeprazole, with that of the H₂-receptor antagonist, ranitidine, as on-demand therapy for relieving symptoms associated with non-erosive reflux disease (NERD).
This is a single center, prospective, randomized, open-label trial of on-demand therapy with rabeprazole (group A) vs ranitidine (group B) for 4 wk. Eighty-three patients who presented to the American University of Beirut Medical Center with persistent gastroesophageal reflux disease (GERD) symptoms and a normal upper gastrointestinal endoscopy were eligible for the study. Patients in group A (n = 44) were allowed a maximum rabeprazole dose of 20 mg twice daily, while those in group B (n = 39) were allowed a maximum ranitidine dose of 300 mg twice daily. Efficacy was assessed by patient evaluation of global symptom relief, scores of the SF-36 quality of life (QoL) questionnaires, total number of pills used, and number of medication-free days.
Among the 83 patients who were enrolled in the study, 76 patients (40 in the rabeprazole group and 36 in the ranitidine group) completed the 4-wk trial. Baseline characteristics were comparable between both groups. After 4 wk, there was no significant difference in the subjective global symptom relief between the rabeprazole and the ranitidine groups (71.4% vs 65.4%, respectively; P = 0.9). There were no statistically significant differences between mean cumulative scores of the SF-36 QoL questionnaire for the two study groups (rabeprazole 22.40 ± 27.53 vs ranitidine 17.28 ± 37.06; P = 0.582). There was no significant difference in the mean number of pills used (rabeprazole 35.70 ± 29.75 vs ranitidine 32.86 ± 26.98; P = 0.66). There was also no statistically significant difference in the mean number of medication-free days between both groups.
Rabeprazole has a comparable efficacy compared to ranitidine when given on-demand for the treatment of NERD. Both medications were associated with improved quality of life.
比较质子泵抑制剂雷贝拉唑与 H₂受体拮抗剂法莫替丁作为按需治疗非糜烂性反流病（NERD）相关症状的疗效。
这是一项在贝鲁特美国大学医学中心进行的单中心、前瞻性、随机、开放标签的按需治疗试验，比较雷贝拉唑（A 组）与法莫替丁（B 组）治疗 4 周的疗效。共有 83 例因持续性胃食管反流病（GERD）症状和正常上消化道内镜而就诊于该中心的患者符合入组条件。A 组（n=44）患者允许最大雷贝拉唑剂量为每日 2 次，每次 20mg，B 组（n=39）患者允许最大法莫替丁剂量为每日 2 次，每次 300mg。通过患者对整体症状缓解的评估、SF-36 生活质量（QoL）问卷评分、所用药物总剂量和无药物天数来评估疗效。
在纳入研究的 83 例患者中，76 例（雷贝拉唑组 40 例，法莫替丁组 36 例）完成了 4 周试验。两组基线特征相似。4 周后，雷贝拉唑组和法莫替丁组的主观整体症状缓解率无显著差异（分别为 71.4%和 65.4%；P=0.9）。两组研究的 SF-36 QoL 问卷的平均累积评分也无统计学差异（雷贝拉唑组 22.40±27.53，法莫替丁组 17.28±37.06；P=0.582）。使用的药物平均剂量也无显著差异（雷贝拉唑组 35.70±29.75，法莫替丁组 32.86±26.98；P=0.66）。两组之间无药物天数的平均差异也无统计学意义。
雷贝拉唑按需治疗 NERD 的疗效与法莫替丁相当。两种药物均能改善生活质量。
