Revicki D A, Sorensen S, Maton P N, Orlando R C
Center for Health Outcomes Research, MEDTAP International, Bethesda MD 20814, USA.
Dig Dis. 1998 Sep-Oct;16(5):284-91. doi: 10.1159/000016878.
This study evaluated changes in health-related quality of life (HRQL) outcomes of once-daily omeprazole compared with ranitidine for the short-term treatment of patients with poorly responsive symptomatic gastroesophageal reflux disease (GERD).
A double-blind, randomized clinical trial, compared omeprazole versus ranitidine for the treatment of poorly responsive GERD. Eligible patients had a history of predominant heartburn symptoms with symptomatic heartburn after 6 weeks of ranitidine treatment. Patients were randomized to omeprazole 20 mg once daily (n = 156) or ranitidine 150 mg twice daily (n = 161) and followed for 8 weeks. Assessments were completed at baseline and after 8 weeks with physician-rated symptoms: Gastrointestinal Symptom Rating Scale (GSRS); Psychological General Well-Being (PGWB) Index; Sleep Scale; Impact on Daily Activities Scale, and Overall Treatment Effect. Primary HRQL endpoints were the GSRS reflux scale and PGWB total score.
No differences between the 2 treatment groups were observed in baseline demographic, clinical or HRQL measures. After 8 weeks, omeprazole-treated patients had greater improvement in GSRS reflux scale scores (p<0.0001) and PGWB total scores (p = 0. 019) compared with ranitidine-treated patients. Significant between group differences favoring omeprazole were also observed in GSRS total scores (p<0.0001), abdominal pain scale scores (p = 0.003), and indigestion scale scores (p = 0.003), Impact on Daily Activities (p = 0.001), PGWB positive well-being (p = 0.015), anxiety (p = 0. 030), and general health scale scores (p = 0.010). Patient ratings of overall treatment effect demonstrated the significantly (p<0. 0001) greater benefits of omeprazole (mean = 5.26) compared with ranitidine treatment (mean = 3.83).
Omeprazole treatment significantly reduced persistent reflux-related symptoms and normalized psychological well-being compared with ranitidine in poorly responsive symptomatic patients with GERD.
本研究评估了每日一次服用奥美拉唑与雷尼替丁相比,在短期治疗症状性胃食管反流病(GERD)反应不佳患者中健康相关生活质量(HRQL)结局的变化。
一项双盲、随机临床试验,比较了奥美拉唑与雷尼替丁治疗反应不佳的GERD。符合条件的患者有主要烧心症状病史,且在雷尼替丁治疗6周后仍有症状性烧心。患者被随机分为每日一次服用20mg奥美拉唑(n = 156)或每日两次服用150mg雷尼替丁(n = 161),并随访8周。在基线和8周后完成评估,评估内容包括医生评定的症状:胃肠道症状评定量表(GSRS);心理总体幸福感(PGWB)指数;睡眠量表;对日常活动的影响量表,以及总体治疗效果。主要的HRQL终点是GSRS反流量表和PGWB总分。
在基线人口统计学、临床或HRQL测量方面,两个治疗组之间未观察到差异。8周后,与雷尼替丁治疗的患者相比,奥美拉唑治疗的患者在GSRS反流量表评分(p<0.0001)和PGWB总分(p = 0.019)方面有更大改善。在GSRS总分(p<0.0001)、腹痛量表评分(p = 0.003)、消化不良量表评分(p = 0.003)、对日常活动的影响(p = 0.001)、PGWB积极幸福感(p = 0.015)、焦虑(p = 0.030)和总体健康量表评分(p = 0.010)方面也观察到有利于奥美拉唑的显著组间差异。患者对总体治疗效果的评分显示,与雷尼替丁治疗(平均 = 3.83)相比,奥美拉唑(平均 = 5.26)有显著更大的益处(p<0.0001)。
在症状性GERD反应不佳的患者中,与雷尼替丁相比,奥美拉唑治疗显著减轻了持续的反流相关症状,并使心理健康恢复正常。