Clinical characteristics of elderly patients with proton pump inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who responded to rikkunshito

被引：21

作者：

Sakata, Yasuhisa ^{[1
]}

Tominaga, Kazunari ^{[2
]}

Kato, Mototsugu ^{[3
]}

Takeda, Hiroshi ^{[4
]}

Shimoyama, Yasuyuki ^{[5
]}

Takeuchi, Toshihisa ^{[6
]}

Iwakiri, Ryuichi ^{[7
]}

Furuta, Kenji ^{[8
]}

Sakurai, Kouichi ^{[9
]}

Odaka, Takeo ^{[10
]}

Kusunoki, Hiroaki ^{[11
]}

Nagahara, Akihito ^{[12
]}

Iwakiri, Katsuhiko ^{[13
]}

Furuta, Takahisa ^{[14
]}

Murakami, Kazunari ^{[15
]}

Miwa, Hiroto ^{[16
]}

Kinoshita, Yoshikazu ^{[8
]}

Haruma, Ken ^{[11
]}

Takahashi, Shin'ichi ^{[17
]}

Watanabe, Sumio ^{[12
]}

Higuchi, Kazuhide ^{[6
]}

Fujimoto, Kazuma ^{[1
]}

Kusano, Motoyasu ^{[5
]}

Arakawa, Tetsuo ^{[2
]}

机构：

[1] Saga Med Sch, Dept Internal Med & Gastroenterol, Saga 8498501, Japan

[2] Osaka City Univ, Grad Sch Med, Dept Gastroenterol, Osaka 558, Japan

[3] Hokkaido Univ Hosp, Div Endoscopy, Sapporo, Hokkaido, Japan

[4] Hokkaido Univ, Fac Pharmaceut Sci, Dept Pathophysiol & Therapeut, Sapporo, Hokkaido 060, Japan

[5] Gunma Univ Hosp, Dept Endoscopy & Endoscop Surg, Gunma, Japan

[6] Osaka Med Coll, Dept Internal Med 2, Osaka, Japan

[7] Saga Med Sch, Dept Internal Med & Gastrointestinal Endoscopy, Saga 8498501, Japan

[8] Shimane Univ, Sch Med, Dept Gastroenterol & Hepatol, Matsue, Shimane, Japan

[9] Kumamoto Univ, Grad Sch Med, Dept Gastroenterol, Kumamoto, Japan

[10] Chiba Univ, Grad Sch Med, Dept Gastroenterol, Chiba, Japan

[11] Kawasaki Med Sch, Dept Gastroenterol, Kawasaki, Kanagawa, Japan

[12] Juntendo Univ, Dept Gastroenterol, Juntendo, Japan

[13] Chiba Hokusoh Hosp, Nippon Med Sch, Dept Internal Med, Nippon, Japan

[14] Hamamatsu Univ Sch Med, Clin Res Ctr, Hamamatsu, Shizuoka 4313192, Japan

[15] Oita Univ, Fac Med, Dept Gastroenterol, Oita 87011, Japan

[16] Hyogo Coll Med, Dept Internal Med, Div Upper Gastroenterol, Nishinomiya, Hyogo, Japan

[17] Kyorin Med Coll, Dept Internal Med 3, Kyorin, Japan

来源：

BMC GASTROENTEROLOGY | 2014年 / 14卷

关键词：

Gastroesophageal reflux; Acid-related dysmotility; Postprandial; Herbal medicine; Elderly patient; SYMPTOMS; GERD; EPIDEMIOLOGY; PREVALENCE; EFFICACY; MEDICINE; SCALE;

D O I：

10.1186/1471-230X-14-116

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: The incidence and severity of gastroesophageal reflux disease (GERD) in Japan tends to increase in elderly women. Rikkunshito (RKT), a traditional Japanese medicine, acts as a prokinetic agent and improves gastric emptying and gastric accommodation. Our previous prospective randomized placebo-controlled study showed that RKT combined with a standard-dose of rabeprazole (RPZ) significantly improved the acid-related dysmotility symptoms (ARD) in elderly patients with proton pump inhibitor (PPI)-refractory non-erosive reflux disease (NERD). This study aimed to evaluate clinical characteristics of elderly PPI-refractory NERD patients with ARD symptoms who responded to RKT. Methods: Two hundred forty-two patients with PPI-refractory NERD were randomly assigned to 8 weeks of either RPZ (10 mg/q.d.) + RKT (7.5 g/t.i.d.) (RKT group) or RPZ + placebo (PL group). Among them, 95 were elderly (>= 65 years) with ARD (RKT group: n = 52; PL group: n = 43). We analyzed the changes using the 12 subscale score of frequency scale for the symptoms of GERD (FSSG) and 15 items of the Gastrointestinal Symptom Rating Scale at 4 and 8 weeks and compared the therapeutic efficacy between the 2 groups. Results: There were no marked differences in baseline demographic or clinical characteristics in the 2 groups except for rate of current smoking. The FSSG score (mean +/- SD at 0, 4, and 8 weeks) in both the RKT (16.0 +/- 7.0; 9.9 +/- 8.4; 7.0 +/- 6.4) and PL (15.1 +/- 6.4; 10.9 +/- 6.7, 11.1 +/- 8.5) groups significantly decreased after treatment. However, the degree of improvement of total and ARD scores of FSSG after the 8-week treatment was significantly greater in the RKT group than in the PL group. Combination therapy with RKT for 8 weeks showed significant improvement in 3 subscale scores (abdominal bloating, heavy feeling in stomach and sick feeling after meals) of the ARD domain and 1 subscale score (heartburn after meals) of the reflux symptom domain. Conclusions: RKT may be useful for improving GERD symptoms in elderly PPI-refractory NERD patients with ARD. Thus, RKT was particularly effective for resolving postprandial GERD symptoms (heavy feeling in stomach, sick feeling, and heartburn after meals).

引用

页数：10

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