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中国一家三级医疗中心抗反流黏膜瓣膜成形术与质子泵抑制剂治疗胃食管反流病患者的比较:一项随机对照试验的研究方案

Antireflux mucosal valvuloplasty versus proton pump inhibitors for the treatment of patients with gastro-oesophageal reflux disease in a tertiary healthcare centre in China: study protocol for a randomised controlled trial.

作者信息

Lv Xiaofen, Ma Wenlong, Zeng Yunqing, Lu Jiaoyang

机构信息

Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China

出版信息

BMJ Open. 2024 Dec 22;14(12):e088970. doi: 10.1136/bmjopen-2024-088970.

DOI:10.1136/bmjopen-2024-088970
PMID:39773838
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11667400/
Abstract

INTRODUCTION

Endoscopic antireflux therapy has shown promising potential in the treatment for gastro-oesophageal reflux disease (GERD). However, there is currently no universally accepted standard for endoscopic surgery. Therefore, we introduced antireflux mucosal valvuloplasty (ARMV), an innovative endoscopic treatment for GERD. We have conducted a cohort study to assess the association between ARMV and clinical outcomes, including risks and benefits. The objective of this trail is to compare the efficacy of ARMV with proton pump inhibitors (PPIs) therapy.

METHODS AND ANALYSIS

74 patients with chronic GERD will be randomised (1:1) to undergo either ARMV or continue PPI therapy. The primary endpoint is the GERD health-related quality of life score, measured 6 months postprocedure. Secondary endpoints include the GERD questionnaire score, presence of reflux oesophagitis, appearance of the mucosal flap, DeMeester score, PPI usage and the incidence of adverse events. After 6 months, crossover is allowed for the PPI group. Assessments will occur at baseline and at 3, 6, 12, 24 and 36 months postintervention.

ETHICS AND DISSEMINATION

The study protocol has been approved by the Institutional Review Board of Qilu Hospital, Shandong University. Study results will be disseminated through peer-reviewed journals and presented at scientific conferences.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (NCT06348420).

摘要

引言

内镜抗反流治疗在胃食管反流病(GERD)的治疗中显示出了有前景的潜力。然而,目前尚无普遍接受的内镜手术标准。因此,我们引入了抗反流黏膜瓣膜成形术(ARMV),这是一种用于GERD的创新性内镜治疗方法。我们进行了一项队列研究,以评估ARMV与临床结果之间的关联,包括风险和益处。本试验的目的是比较ARMV与质子泵抑制剂(PPI)治疗的疗效。

方法与分析

74例慢性GERD患者将被随机分组(1:1),分别接受ARMV或继续PPI治疗。主要终点是术后6个月测量的GERD健康相关生活质量评分。次要终点包括GERD问卷评分、反流性食管炎的存在、黏膜瓣的外观、DeMeester评分、PPI使用情况及不良事件发生率。6个月后,PPI组允许交叉治疗。评估将在基线以及干预后3、6、12、24和36个月进行。

伦理与传播

本研究方案已获得山东大学齐鲁医院机构审查委员会的批准。研究结果将通过同行评审期刊进行传播,并在科学会议上展示。

试验注册号

ClinicalTrials.gov(NCT06348420)。

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本文引用的文献

1
Two-year outcomes of anti-reflux mucosectomy in treating gastroesophageal reflux disease: A Chinese prospective cohort study.抗反流黏膜切除术治疗胃食管反流病的两年疗效:一项中国前瞻性队列研究。
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Endoscopic construction of an antireflux mucosal barrier for the treatment of GERD: a pilot study (with video).内镜下构建抗反流黏膜屏障治疗 GERD:一项初步研究(附视频)。
Gastrointest Endosc. 2023 Dec;98(6):1017-1022. doi: 10.1016/j.gie.2023.08.017. Epub 2023 Sep 1.
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Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease.抗反流黏膜切除术与射频能量传递治疗质子泵抑制剂难治性胃食管反流病的随机对照试验
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Long-term efficacy of antireflux mucosectomy in patients with refractory gastroesophageal reflux disease.抗反流黏膜切除术治疗难治性胃食管反流病的长期疗效。
Dig Endosc. 2024 Mar;36(3):305-313. doi: 10.1111/den.14617. Epub 2023 Jul 13.
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Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD).胃食管反流病(GERD)治疗的多学会共识会议及指南
Surg Endosc. 2023 Feb;37(2):781-806. doi: 10.1007/s00464-022-09817-3. Epub 2022 Dec 18.
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Proton Pump Inhibitors in Allergy: Benefits and Risks.质子泵抑制剂在过敏中的作用:获益与风险。
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Outcomes after anti-reflux procedures: Nissen, Toupet, magnetic sphincter augmentation or anti-reflux mucosectomy?抗反流手术后的结果:Nissen、Toupet、磁括约肌增强术或抗反流黏膜切除术?
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