埃索美拉唑治疗反流性食管炎四周和八周的疗效评价

The efficacy of esomeprazole in reflux oesophagitis at 4weeks and 8weeks

目的对埃索美拉唑治疗反流性食管炎的疗效进行系统回顾,并用Meta分析比较埃索美拉唑与其他质子泵抑制剂（PPIs）的治疗效果。方法对2000年1月~2005年12月中国生物医学文摘数据库（CBMdisk）、MEDLINE和Cochrane图书馆的文献进行光盘检索,对入选的埃索美拉唑治疗反流性食管炎疗效的RCT试验进行系统回顾,对各研究结果按照不同的质子泵抑制剂分组进行同质性或异质性检验合并数据。结果埃索美拉唑40mg对反流性食管炎4周和8周的治愈率、治疗4周后烧心症状的缓解率均优于奥美拉唑20mg、兰索拉唑30mg和泮妥拉唑40mg。结论埃索美拉唑40mg对反流性食管炎的治愈率和烧心症状的缓解率略优于奥美拉唑20mg、兰索拉唑30mg和泮妥拉唑40mg。

Objective To evaluate retrospectively the effectiveness of esomeprazole in the therapy of reflux oesophagltis, and compare it with other proton pump inhibitor＇s using meta-analysis method. Methods Randomized controlled trials of the treatments with GERD were searched in Medline, Cochrane library and China Biological Medicine Disk from Jan. 2000 to Dec. 2005. Seven studies were enrolled into this analysis. The detail of the trial design, characteristics of the subjects and the results of the studies were reviewed by two independent authors and analyzed by using Revman 4.2 software. Meta-analysis was done with Fixed Effects model and Random Effects model. Results The results of healing rates when comparing 40mg esomeprazole with 20mg omeprazole in a meta-analysis are as following：at 4 weeks （ relative risk 1. 12;95%CI：1.09,1.16） and 8 weeks（RR 1.14;95% CI： 1.03,127） ,symptom resolution rate （RR 1. 16 ;95% CI：1. 10,1.22）;The results of healing rates when comparing other proton pump inhibitorswith 40mg esomeprazole are as following： 30 mg lansoprazole at 4 weeks （ RR 1. 1 ; 95 % CI ： 0.99,1.23 ） , 8weeks （ RR 1.05 ; 95 % CI ： 1.03,1.06） , symptom resolution rate （ RR 1.06 ; 95 % CI ： 1.02,1.10 ） ; healing rate of 40mg pantoprazole at 4 weeks （ RR 1.07 ; 95% CI： 1. 03, 1.11 ）, 8 weeks （ RR 1. 04; 95% CI： 1.02,1.06）, symptom resolution rate （ RR 1.08 ; 95 % CI ： 1.03,1.12 ）. Conclusion Esomeprazole provides more effective acid control, higher healing rates and better symptom resolution rate than 20mg omeprazole,30mg lansoprazole and 40mg pantoprazole.