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引用本文:胡育军,杨玥凤,叶永昌.右兰索拉唑与埃索美拉唑治疗胃食管反流病的疗效比较[J].中国现代应用药学,2015,32(6):739-745.
HU Yujun,YANG Yuefeng,YE Yongchang.Comparative Efficacy of Dexlansoprazole and Esomeprazole in the Treatment of Gastro-esophageal Reflux Disease[J].Chin J Mod Appl Pharm(中国现代应用药学),2015,32(6):739-745.
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右兰索拉唑与埃索美拉唑治疗胃食管反流病的疗效比较
胡育军1, 杨玥凤2, 叶永昌3
1.兰溪市中医院药剂科,浙江 兰溪 321100;2.浙江医院消化科,杭州310013;3.兰溪市人民医院药剂科,浙江 兰溪 321100
摘要:
目的 比较右兰索拉唑与埃索美拉唑对腐蚀性食管炎(EO)的治疗及维持治疗以及对非腐蚀性反流病(NERD)的治疗疗效。方法 对比兰索拉唑或埃索美拉唑与安慰剂或另一种质子泵抑制剂的随机对照试验(RCT)进行系统性回顾,使用随机效应荟萃分析和经调整的间接比较方法,比较右兰索拉唑与埃索美拉唑的疗效,计算相对危险性(RR)和95%可信区间(CI)。结果 间接比较结果显示,右兰索拉唑组与埃索美拉唑组NERD患者在4周时烧心症状存在显著性差异。右兰索拉唑30 mg剂量与埃索美拉唑20 mg或40 mg剂量相比,具有显著优势(RR:2.01,95% CI:1.15~3.51;RR:2.17,95% CI: 1.39~3.38)。而对EO的治疗及维持治疗,2种药物无显著差异。结论 对NERD患者烧心症状的控制,右兰索拉唑与埃索美拉唑相比具有更好的疗效,但对于EO的治疗疗效两者无显著性差异。本研究结果有待更大样本进一步研究证实。
关键词:  胃食管反流病  右兰索拉唑  埃索美拉唑  疗效  间接比较
DOI:
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基金项目:
Comparative Efficacy of Dexlansoprazole and Esomeprazole in the Treatment of Gastro-esophageal Reflux Disease
HU Yujun1, YANG Yuefeng2, YE Yongchang3
1.Department of Pharmacy, Lanxi Hospital of Traditional Chinese Medicine, Lanxi 321100, China;2.Department of Gastroenterology, Zhejiang Hospital, Hangzhou 310013, China;3.Department of Pharmacy, Lanxi People’s Hospital, Lanxi 321100, China
Abstract:
OBJECTIVE To compare the efficacy of dexlansoprazole with esomeprazole in healing erosive oesophagitis (EO), the maintenance of healed EO and the treatment of non-erosive reflux disease(NERD). METHODS Randomised controlled trials (RCTs) comparing dexlansoprazole or esomeprazole with either placebo or another PPI were systematically reviewed. Random-effect Meta-analyses and adjusted indirect comparisons were conducted to compare the treatment effect of dexlansoprazole and esomeprazole using a common comparator. The relative risk (RR) and 95% confidence interval (CI) were calculated. RESULTS The indirect comparisons revealed significant differences in symptom control of heartburn in patients with NERD at 4?weeks between two drugs: dexlansoprazole 30?mg was more effective than esomeprazole 20?mg or 40?mg (RR: 2.01, 95% CI: 1.15–3.51; RR: 2.17, 95% CI: 1.39–3.38). However, there were no statistically significant differences between the two drugs in EO healing and maintenance of healed EO. CONCLUSION It suggestes significantly better treatment effect in symptom control of heartburn in patients with NERD for dexlansoprazole against esomeprazole. No statistically significant differences are found in other EO outcomes. it is looking forward to have more high quality clinical randomized controlled trials to confirm the findings.
Key words:  gastro-esophageal reflux disease  dexlansoprazole  esomeprazole  treatment efficiency  indirect comparison
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