[Diagnosis and Treatment of GastroEsophageal Reflux Disease at the Primary Health Care Clinics in Korea].

Young Sun Kim, Dong Hoon Kang, Hyun Chul Park, Tae Hoon Oh, Yong Sik Kim
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Abstract

Background/Aims The prevalence of GERD and treatment costs are continuously rising in Korea, and the importance of primary health care clinics where the most treatment of actual patients is conducted is increasing. In this study, the diagnosis of GERD, selection of therapeutic drugs, and treatment methods in primary health care clininics were investigated through a large-scale multi-dimensional surveys. Methods From January 2015 to December 2018, the study data of 18,010 patients with GERD were retrospectively investigated based on eletronic medical record at 542 primary health care clinics in Korea. Results Among all GERD patients, endoscopy was used for diagnosis in 16.11% of cases, and the most frequently performed in gastroenterology department (28.85%). The average BMI and the proportion of patients in stages 1 to 3 of obesity were highest in the ERD group, and the majority of the severity of ERD group was mild. Symptoms of the patients with GERD were mainly heartburn, gastric acid reflux, and chest pain. Drug treatment was performed in most of the patients with GERD, and PPI was the main drug, and Esomeprazol was prescribed the most among the main ingredients, and the ratio of PPI alone was high. The rate of symptom improvement after GERD treatment was slightly higher in the ERD group (75.91%) and the NERD group (74.36%) than in the GERD diagnosed without endoscopy group (63.89%). Conclusions In domestic primary health care clinics, the majority were diagnosed with GERD without endoscopy on the basis of symptoms. The most preferred treatment for GERD was PPI, which was prescribed alone in the majority.
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[韩国初级保健诊所胃食管反流病的诊断和治疗]。
背景/目的:韩国胃食管反流病的患病率和治疗费用不断上升,对实际患者进行最多治疗的初级卫生保健诊所的重要性也在增加。本研究通过大规模多维度调查,对基层卫生保健临床GERD的诊断、治疗药物的选择和治疗方法进行了调查。方法:根据韩国542家初级卫生保健诊所的电子病历,对2015年1月至2018年12月18010例胃食管反流病患者的研究数据进行回顾性调查,ERD组的平均BMI和肥胖1-3期患者比例最高,ERD组大多数严重程度为轻度。GERD患者的症状主要是胃灼热、胃酸反流和胸痛。大多数胃食管反流病患者都进行了药物治疗,PPI是主要药物,在主要成分中,Esomeprazol的处方最多,单独使用PPI的比例很高。ERD组(75.91%)和NERD组(74.36%)的GERD治疗后症状改善率略高于未经内镜诊断的GERD组(63.89%)。胃食管反流病最首选的治疗方法是PPI,它在大多数情况下是单独开的。
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