关于为胃食管反流病患者处方雷贝拉唑和其他常用质子泵抑制剂的专家意见

Manjula S, Krishna Kumar M
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摘要

研究目的本调查研究旨在进一步了解专家对临床实践中常用处方 PPIs 的看法,特别关注在印度环境中使用口服雷贝拉唑 20 毫克作为胃食管反流病(GERD)维持疗法的情况。调查方法:通过 25 个问题的问卷调查,收集了印度各地区专家对雷贝拉唑 20 毫克和其他质子泵抑制剂 (PPI) 治疗胃食管反流症状处方实践的看法。研究结果在 512 名研究参与者中,44% 的人表示肥胖是胃食管反流病患者常见的合并症,28% 的人指出合并糖尿病。68%的受访者认为,雷贝拉唑在起效快、服药后24小时内维持胃内pH值大于4以及减少夜间胃灼热等方面优于其他PPIs。对于患有功能性消化不良和胃痉挛的胃食管反流病患者,52% 的应答者赞成在 PPI 治疗的基础上加用多潘立酮作为促动力药物。此外,大多数参与者(61.91%)观察到,雷贝拉唑 20 毫克不会导致胃排空延迟,也不会提高胃食管反流病患者的体泌素水平或改变动情素的基线水平。这些发现强调了雷贝拉唑 20 毫克与奥美拉唑和兰索拉唑相比的有效性。结论对于同时患有肥胖症和糖尿病的胃食管反流病患者,专家建议首选雷贝拉唑 20 毫克,而不是奥美拉唑和兰索拉唑。此外,半数以上的受访者表示,对于患有功能性消化不良和胃痉挛的胃食管反流病患者,可联合使用多潘立酮和其他 PPIs。
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Expert Opinion on the Prescription Practice of Rabeprazole and Other Common Proton Pump Inhibitors for Patients with Gastroesophageal Reflux Disease
Objective: The current survey-based study aims to provide further insights on expert opinion regarding the commonly prescribed PPIs in clinical practice, with a specific focus on the use of oral rabeprazole 20 mg as a treatment for gastroesophageal reflux disease (GERD) maintenance therapy in Indian settings. Methodology: The questionnaire-based survey involving 25 questions collected perspectives of experts across various regions of India regarding the prescription practice of rabeprazole 20 mg and other proton-pump inhibitors (PPIs) for treating GERD symptoms. Results: Out of 512 study participants, 44% reported obesity as the common comorbid condition observed in GERD patients, while 28% noted co-morbid diabetes mellitus. According to 68% of the respondents, rabeprazole demonstrated superiority over other PPIs in terms of quicker onset of action, maintaining intragastric pH >4 over 24 hours’ post-dose, and reduced nighttime heartburn. For GERD patients with functional dyspepsia and gastroparesis, 52% of responders favored the addition of domperidone as a prokinetic drug to the PPI treatment. Moreover, the majority of participants (61.91%) observed that rabeprazole 20 mg did not cause a delay in stomach emptying, nor did it raise somatostatin levels or alter baseline motilin levels in GERD patients. These findings underscore the effectiveness of rabeprazole 20 mg in comparison to omeprazole and lansoprazole. Conclusion: Experts recommended rabeprazole 20 mg as the preferred treatment option over omeprazole and lansoprazole for GERD patients with coexisting obesity and diabetes mellitus conditions. Additionally, over half of the respondents reported using a combination of domperidone and other PPIs for GERD patients with functional dyspepsia and gastroparesis.
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