Department of Internal Medicine, Nakatsugawa City National Health Insurance Sakashita Hospital, 722-1 Sakashita, Nakatsugawa, Gifu 509-9293, Japan.
J Clin Biochem Nutr. 2013 Jan;52(1):76-81. doi: 10.3164/jcbn.12-69. Epub 2012 Nov 13.
We investigated comparison according to reflux esophagitis and non-erosive reflux disease about "daily" symptom improvement for proton pump inhibitor treatment. We enrolled 57 reflux esophagitis and 90 non-erosive reflux disease patients. They took rabeprazole 10 mg/day for 28 days and completed "daily" in the Frequency Scale for the Symptoms of GERD from baseline until day 14, and after 28 days of treatment. The efficacy endpoint was the improvement rates in Frequency Scale for the Symptoms of GERD, based on baseline. Frequency Scale for the Symptoms of GERD was decreased in reflux esophagitis and non-erosive reflux disease (p<0.001) and was significantly lower in reflux esophagitis than in non-erosive reflux disease from the first day of treatment (p<0.05). Symptomatic improvement rates were also significantly higher in reflux esophagitis (50.3 ± 44.9%) than in non-erosive reflux disease (31.7 ± 43.2%) from the first day of treatment (p<0.0001). The symptomatic improvement rates in reflux esophagitis were significant increased from the second day of treatment until after 28 days of treatment (p = 0.0006), however, these in non-erosive reflux disease were significant increased from third days until after 28 days of treatment (p = 0.0002). In non-erosive reflux disease, the improvement of dysmotility symptom was particularly gradual as well as of reflux symptom, too. As for results of prediction of proton pump inhibitor response (completed symptom resolution) form early symptom improvement within 1 week, it was able to predict proton pump inhibitor response from the symptom improvement rate on 3 days in reflux esophagitis and on day 7 in non-erosive reflux disease. In conclusion, the prediction of the proton pump inhibitor response in non-erosive reflux disease was slow in comparison with reflux esophagitis. The cause was gradual improvement of dysmotility symptom.
我们调查了质子泵抑制剂治疗中“每日”症状改善与反流性食管炎和非糜烂性反流病的比较。我们纳入了 57 例反流性食管炎和 90 例非糜烂性反流病患者。他们服用雷贝拉唑 10mg/天,共 28 天,并在基线至第 14 天以及治疗 28 天后完成 GERD 症状频率量表的“每日”评估。疗效终点是基于基线的 GERD 症状频率量表改善率。反流性食管炎和非糜烂性反流病的 GERD 症状频率量表均降低(p<0.001),且从治疗第一天开始,反流性食管炎的 GERD 症状频率量表显著低于非糜烂性反流病(p<0.05)。从治疗第一天开始,反流性食管炎的症状改善率(50.3±44.9%)也显著高于非糜烂性反流病(31.7±43.2%)(p<0.0001)。从治疗第二天开始,反流性食管炎的症状改善率显著增加,直至治疗 28 天后(p=0.0006),而非糜烂性反流病则从第三天开始直至治疗 28 天后(p=0.0002)。非糜烂性反流病中,动力障碍症状的改善与反流症状一样缓慢。对于在 1 周内的早期症状改善预测质子泵抑制剂反应(症状完全缓解)的结果,它可以从反流性食管炎的 3 天症状改善率和非糜烂性反流病的第 7 天症状改善率预测质子泵抑制剂的反应。总之,与反流性食管炎相比,非糜烂性反流病质子泵抑制剂反应的预测较慢。原因是动力障碍症状的改善较为缓慢。