Proton pump inhibitor step-down therapy for GERD:A multi-center study in Japan

作     者：Takao Tsuzuki Hiroyuki Okada Yoshiro Kawahara Ryuta Takenaka Junichiro Nasu Hidehiko Ishioka Akiko Fujiwara Fumiya Yoshinaga Kazuhide Yamamoto 

作者机构：Department of Gastroenterology and HepatologyOkayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Internal MedicineTsuyama Central HospitalOkayama 708-0841Japan Ishioka clinicHiroshima 721-0926Japan Department of Internal MedicineOkayama Saiseikai General HospitalOkayama 700-8511Japan Deparment of Internal MedicineMihara Red Cross HospitalHiroshima 723-8512Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第11期

页      面：1480-1487页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：质子泵抑制剂 治疗 降压 多中心 日本 症状自评量表 消化不良 生活质量 

摘      要：AIM:To investigate the predictors of success in stepdown of proton pump inhibitor and to assess the quality of life(QOL).METHODS:Patients who had heartburn twice a week or more were treated with 20 mg omeprazole(OPZ) once daily for 8 wk as an initial therapy(study 1).Patients whose heartburn decreased to once a week or less at the end of the initial therapy were enrolled in study 2 and treated with 10 mg OPZ as maintenance therapy for an additional 6 mo(study 2).QOL was in-vestigated using the gastrointestinal symptom rating scale(GSRS)before initial therapy,after both 4 and 8 wk of initial therapy,and at 1,2,3,and 6 mo after starting maintenance ***:In study 1,108 patients were *** characteristics were as follows;median age:63(range: 20-88)years,sex:46 women and 62 *** success rate of the initial therapy was 76%.In the patients with successful initial therapy,abdominal pain,indigestion and reflux GSRS scores were *** study 2,83 patients were *** of 83 patients completed the study 2 *** the per-protocol analysis,80%of 70 patients were successful for *** multivariate analysis of baseline demographic data and clinical information,no previous treatment for gastroesophageal reflux disease(GERD)[odds ratio (OR)0.255,95%CI:0.06-0.98]and a lower indigestion score in GSRS at the beginning of step-down therapy(OR 0.214,95%CI:0.06-0.73)were found to be the predictors of successful step-down *** improved GSRS scores by initial therapy were maintained through the step-down ***:OPZ was effective for most GERD ***,those who have had previous treatment for GERD and experience dyspepsia before stepdown require particular monitoring for relapse.