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度洛西汀联合兰索拉唑对胃食管反流病患者症状及生活质量改善的影响:一项随机双盲临床试验。

The effect of adding duloxetine to lansoprazole on symptom and quality of life improvement in patients with gastroesophageal reflux diseases: A randomized double-blind clinical trial.

作者信息

Mokhtare Marjan, Chaharmahali Arezoo, Bahardoust Mansour, Ghanbari Atefeh, Sarveazad Arash, Naghshin Roozbeh, Abbaskhanidavanloo Farbod

机构信息

Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.

Department Internal Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Res Med Sci. 2021 Jan 28;26:4. doi: 10.4103/jrms.JRMS_300_19. eCollection 2021.

Abstract

BACKGROUND

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder with a negative impact on the quality of life. This study was aimed to assess the effect of adding duloxetine to lansoprazole on the symptom and quality of life improvement in GERD patients.

MATERIALS AND METHODS

Seventy adult patients with a complaint of heartburn and regurgitation were enrolled in this randomized trial. Patients with a history of atypical symptoms, advanced systemic disease, medication-induced symptom, structural lesion in endoscopy, allergy to the medication, and unco-operative were excluded. The patients randomly (computer generated table) assigned in Groups A who received lansoprazole 30 mg plus placebo daily and Group B, in which duloxetine 30 mg daily replaced by placebo during 4 weeks. All of participants, care-givers, and outcomes assessors were blinded. Basic demographic data, symptom severity score, depression and anxiety Beck score, and quality of life questionnaire were recorded at the starting and ending of treatment.

RESULTS

Fifty-four patients have completed the study. The mean difference of Anxiety Beck score (13, 95% confidence interval [CI] [10-16], = 0.001) and total raw score of quality of life (7, 95% CI [3.89-10.11], = 0.043) were significantly improved in Group B. Complete and overall heartburn improvement rates were significantly better in Group B (odds ratio [OR] Adj: 2.01, 95% CI [1.06-2.97] and OR Adj: 1.31, 95% CI [1.05-1.57], respectively).

CONCLUSION

We found that the combination of duloxetine and lansoprazole is a safe and tolerable regimen, and it can significantly improve anxiety, heartburn, coffee consumption, the quality of sleep, and life in patients who suffer from the symptoms of GERD.

摘要

背景

胃食管反流病(GERD)是一种常见的上消化道疾病,对生活质量有负面影响。本研究旨在评估在兰索拉唑基础上加用度洛西汀对GERD患者症状及生活质量改善的影响。

材料与方法

70例有烧心和反流症状的成年患者纳入本随机试验。排除有非典型症状史、晚期全身性疾病、药物性症状、内镜检查有结构性病变、对药物过敏及不配合的患者。患者随机(计算机生成表格)分为A组,每日服用兰索拉唑30mg加安慰剂;B组,在4周内每日用度洛西汀30mg替代安慰剂。所有参与者、护理人员和结果评估者均为盲法。记录治疗开始和结束时的基本人口统计学数据、症状严重程度评分、抑郁和焦虑贝克评分以及生活质量问卷。

结果

54例患者完成研究。B组焦虑贝克评分的平均差异(13,95%置信区间[CI][10 - 16],P = 0.001)和生活质量总原始评分(7,95%CI[3.89 - 10.11],P = 0.043)有显著改善。B组烧心完全缓解率和总体缓解率显著更好(调整后的优势比[OR]分别为:2.01,95%CI[1.06 - 2.97]和OR调整后为:1.31,95%CI[1.05 - 1.57])。

结论

我们发现度洛西汀与兰索拉唑联合使用是一种安全且可耐受的治疗方案,它能显著改善GERD症状患者的焦虑、烧心、咖啡摄入量、睡眠质量和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c517/8103956/1016c077aff9/JRMS-26-4-g001.jpg

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