食道超警和粘膜完整性预测了正常酸暴露的反流患者的症状结果
Wei-Yi Lei1, Jen-Hung Wang2, Chandra Prakash Gyawali3
1Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
Neurogastroenterology and motility
|April 29, 2025
概括
用正常的酸性暴露来治疗逆流需要解决食道过度警. 减少这种心理因素,以及药物治疗,比单独使用阿尔基纳酸盐或质子抑制剂更能改善症状.
科学领域:
- 胃肠病学 胃肠病学
- 精神病体医学是一种精神病体医学.
背景情况:
- 在正常的酸暴露下管理食道症状是具有挑战性的,需要关注生理和心理因素.
- 在这种情况下,很少有研究探讨了患者对阿尔基纳酸盐或质子抑制剂 (PPI) 症状变化的看法.
- 这项研究研究了用阿尔金酸盐或PPI治疗的正常酸暴露患者的症状变化,食道过敏和心理困扰.
研究的目的:
- 检查反流症状严重程度的变化,食道过度警和心理困扰之间的相互关系.
- 在正常食道酸暴露的患者中,评估阿尔金酸盐悬浮剂和PPI治疗之间的症状变化和预测因素.
主要方法:
- 一项为期2年的前性随机开放性研究,涉及146名通过pH阻抗监测证实正常酸暴露的患者.
- 参与者填写了关于食道过敏和焦虑 (EHAS),症状严重程度,睡眠质量和抑郁症在基线和随访时的验证问卷.
- 分析包括评估阿尔金酸盐和PPI治疗组之间的症状变化和预测因素.
主要成果:
- 在阿尔金酸盐和PPI组 (p < 0.001) 观察到问卷分数的显著改善,没有跨组差异.
- 很少有患者在两种治疗中都实现了GERDQ和GSS分数>50%的降低.
- 减少食道过敏和较低的平均夜间基线阻抗 (MNBI) 是症状改善的显著预测因素.
结论:
- 无论是PPI还是阿尔基纳酸单独有效地改善了正常酸暴露的反流患者的症状.
- 减少食道过度警和焦虑显著改善了结果,独立于治疗类型.
- 食道过敏和焦虑评分是治疗反应的关键预测指标,强调需要采用综合方法来解决心理和生理因素.
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