食管保护剂治疗伴有食管外症状的胃食管反流病的疗效:一项多中心、开放标签、观察性研究

Yu.A. Kucheryavy, D. N. Andreyev, E. Eryomina, A. Gilmanov, O. V. Nazarova, Ye. A. Sidneva, Y. Topalova
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引用次数: 0

摘要

目的:评价食管保护剂阿法索对胃食管反流患者食管外症状的影响。材料和方法。进行了一项前瞻性开放式多中心注册后观察性研究。该研究包括546名年龄在6至85岁之间(患者平均年龄为42.4±16.9岁)的患者,确诊为胃食管反流(内窥镜检查和/或ph测量),存在该疾病的食管外症状(根据客观检查和专家咨询的结果),主治医生根据医疗使用说明使用医疗器械Alfasoxx开了一个疗程。这些患者是由俄罗斯26个城市的51名研究人员招募的。该研究按时间顺序包括一次筛查访问和两次记录访问(在使用Alfasoxx食管保护器的框架内的观察期)。筛查访问在患者入院当天进行。访视1可以在筛查访视当天进行,而访视2则在访视1结束后4-5周进行。结果显示,研究结束时,42.7% (95% CI: 38.5-46.9)的患者食管外反流症状完全消失(问卷RSI = 0分)。当比较治疗前后RSI总分的平均值时,从第一次就诊时的13.8分(95% CI: 13.2-14.4)到第二次就诊时的2.0分(95% CI: 1.8-2.2)也有统计学意义的回归。因此,总分的下降是显著的,超过了初始值的80%。在分析治疗前后RSI量表单项指标的动态变化时,发现所有疾病症状的严重程度都有显著的回归。此外,结果显示,患者在第一次就诊时服用含抗酸药物的比例从58.2% (95% CI: 54.0-62.4)显著下降到第二次就诊时的15.2% (95% CI: 12.1-18.3)。治疗满意度的Likert量表平均得分为4.8分(95% CI: 4.8 ~ 4.9),而使用阿法索的方便性为4.7分。这项前瞻性多中心观察性研究表明,在标准反食管反流治疗中加入Alfasoxx有助于显著缓解食管和食管外症状,并减少抗酸药物的需求。
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Efficacy of Esophageal Protector in Treating Gastroesophageal Reflux Disease with Extraesophageal Symptoms: a Multicenter, Open-Label, Observational Study
Aim: to assess effects of esophageal protector Alfasoxx on extraesophageal symptoms in patients with GERD.Materials and methods. A prospective open multicenter post-registration observational study was conducted. The study included 546 patients aged 6 to 85 years (the average age of patients is 42.4 ± 16.9 years) with a verified diagnosis of GERD (endoscopically and/or pH-metrically), the presence of extraesophageal symptoms of the disease (according to the results of an objective examination and consultations of specialists), to whom the attending physician prescribed a course of treatment with a medical device Alfasoxx in accordance with the instructions for medical use. The patients were recruited by 51 researchers in 26 cities of Russia. The study in chronological order consisted of a screening visit and two recorded visits (the observation period within the framework of the use of the Alfasoxx esophagoprotector). The screening visit was conducted on the day of the patient's admission. Visit 1 could be conducted on the same day as the screening visit, whereas visit 2 was conducted 4–5 weeks after visit 1 at the end of the course of treatment.Results. According to the results obtained, at the end of the study, 42.7 % (95 % CI: 38.5–46.9) had complete disappearance of extraesophageal GERD symptoms (questionnaire RSI = 0 points). When comparing the average values of the total RSI score before and after treatment, there was also a statistically significant regression from 13.8 points (95 % CI: 13.2–14.4) at visit 1 to 2.0 points (95 % CI: 1.8–2.2) at visit 2. Thus, the decrease in the total score was significant and exceeded 80 % of the initial value. When analyzing the dynamics of individual indicators of the RSI scale before and after treatment, a significant regression in the severity of all symptoms of the disease was noted. In addition, the results showed that the proportion of patients taking antacid-containing drugs at visit 1 significantly decreased from 58.2 % (95 % CI: 54.0–62.4) to 15.2 % (95 % CI: 12.1–18.3) by visit 2. The average score on the Likert scale of satisfaction with treatment was 4.8 (95 % CI: 4.8–4.9), whereas the convenience of using Alfasoxx is 4.7.Conclusion. This prospective observational multicenter study demonstrated that the addition of Alfasoxx to standard GERD therapy contributes to a significant regression of both esophageal and extraesophageal symptoms, as well as a decrease in the need for antacid medications.
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