He Suyu, Xu Fei, Xiong Xin, Wang Hui, Cao Lipeng, Liang Ninglin, Wang Hanmei, Jing Xiaojuan, Liu Tianyu
The Fourth Department of the Digestive Disease Center.
The Fifth Department of the Digestive Disease Center.
Medicine (Baltimore). 2020 Jan;99(3):e18610. doi: 10.1097/MD.0000000000018610.
To compare the Stretta procedure with proton pump inhibitors for the treatment of nonerosive reflux disease (NERD).From July 2018 to April 2019, patients diagnosed with NERD and referred for treatment were enrolled. They were treated with either Stretta procedure or proton pump inhibitor (PPI) medication and followed-up for 6 months. The symptom control, quality of life, lower esophageal sphincter (LES) pressure, 24-hour pH parameters, PPI usage and satisfaction rate were evaluated. The complications were assessed. The outcomes of the 2 groups were analyzed and compared.Twenty-eight patients in the Stretta group and 21 patients in the PPI group completed the 6-month follow-up. No severe adverse events occurred in both groups. Both interventions were effective in improvement of symptom and quality of life. The symptom score improvement was significantly superior in the Stretta group compared to the PPI group (6.3 ± 3.4 vs 8.5 ± 4.1, P = .03). LES pressure increased significantly in the Stretta group compared to the PPI group (14.2 ± 4.4 mm Hg vs 10.0 ± 4.0 mm Hg, P < .01). Although both interventions improved 24-hour pH parameters, including number of acid episodes (P = .27), acid exposure time (P = .39), and DeMeester score (P = .28), no difference was found between the 2 groups. Complete PPI cessation rate (82% vs 52%, P = .03) as well as satisfaction rate (89% vs 57%, P = .02) was much higher in Stretta group than those in the PPI groupThe Stretta procedure was safe and effective in the short term for the management of NERD. The Stretta procedure resulted in higher LES pressure and achieved better improvement of symptom control and PPI cessation than did PPI in the short term.
比较Stretta手术与质子泵抑制剂治疗非糜烂性反流病（NERD）的效果。2018年7月至2019年4月，纳入诊断为NERD并转诊接受治疗的患者。他们接受了Stretta手术或质子泵抑制剂（PPI）药物治疗，并随访6个月。评估症状控制、生活质量、食管下括约肌（LES）压力、24小时pH参数、PPI使用情况和满意率。评估并发症。分析并比较两组的结果。Stretta组28例患者和PPI组21例患者完成了6个月的随访。两组均未发生严重不良事件。两种干预措施均能有效改善症状和生活质量。与PPI组相比，Stretta组的症状评分改善明显更优（6.3±3.4 vs 8.5±4.1，P = 0.03）。与PPI组相比，Stretta组的LES压力显著升高（14.2±4.4 mmHg vs 10.0±4.0 mmHg，P < 0.01）。虽然两种干预措施均改善了24小时pH参数，包括酸反流发作次数（P = 0.27）、酸暴露时间（P = 0.39）和DeMeester评分（P = 0.28），但两组之间未发现差异。Stretta组的PPI完全停药率（82% vs 52%，P = 0.03）和满意率（89% vs 57%，P = 0.02）均远高于PPI组。Stretta手术在短期内治疗NERD安全有效。与PPI相比，Stretta手术在短期内可使LES压力升高，症状控制改善更好，PPI停药率更高。
