Short-term and long-term effect of diaphragm biofeedback training in gastroesophageal reflux disease: an open-label, pilot, randomized trial.
Short-term and long-term effect of diaphragm biofeedback training in gastroesophageal reflux disease: an open-label, pilot, randomized trial.
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膈肌生物反馈训练对胃食管反流病的短期和长期影响：一项开放标签、试点、随机试验。
DOI：
10.1111/dote.12390
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Mei
中科院分区：
文献类型：
--
作者：
X. Sun;W. Shang;Zhi Feng Wang;Xiao;Xiu Cai Fang;Mei
本研究旨在探讨膈肌生物反馈训练（DBT）对胃食管反流病（GERD）患者的有效性。2004年9月至2006年7月期间在北京协和医院接受治疗的40例GERD患者随机接受DBT和雷贝拉唑质子泵抑制剂（PPI）或雷贝拉唑单药治疗。DBT +雷贝拉唑组在8周的初始治疗期间接受DBT;雷贝拉唑组没有。随访6个月，所有患者根据反流症状采取抑酸治疗，DBT +雷贝拉唑组继续DBT治疗。主要结局（用于功效分析）是6个月时使用的抑酸量。次要结局是8周治疗后与基线相比的反流症状、健康相关生活质量（HRQL）和食管动力差异。6个月时，DBT +雷贝拉唑组抑酸剂用量较雷贝拉唑组显著减少（P < 0.05）。治疗8周时，两组反流症状和GERD-HRQL均明显改善（P < 0.05），但两组间无差异。DBT +雷贝拉唑组膈肌张力（CDT）和胃食管交界处压力（GEJP）显著升高（P < 0.05），而下食管括约肌（LES）压力无明显变化。与基线相比，雷贝拉唑组的CDT、GEJP和LES压力无显著变化。总之，长期DBT可以通过增强抗反流屏障、提供非药物维持治疗和降低GERD患者的医疗费用来减少抑酸剂的使用。
This study investigated the effectiveness of diaphragm biofeedback training (DBT) for patients with gastroesophageal reflux disease (GERD). A total of 40 patients with GERD treated at the Peking Union Medical College Hospital between September 2004 and July 2006 were randomized to receive DBT and rabeprazole proton pump inhibitor (PPI) or rabeprazole alone. The DBT + rabeprazole group received DBT during the 8-week initial treatment; the rabeprazole group did not. During the 6-month follow up, all patients took acid suppression according to their reflux symptoms, and the patients in the DBT + rabeprazole group were required to continue DBT. The primary outcome (used for power analysis) was the amount of acid suppression used at 6 months. Secondary outcomes were reflux symptoms, health-related quality of life (HRQL), and esophageal motility differences after the 8-week treatment compared with baseline. Acid suppression usage significantly decreased in the DBT + rabeprazole group compared with the rabeprazole group at 6 months (P < 0.05). At 8 weeks, reflux symptoms and GERD-HRQL were significantly improved in both groups (P < 0.05), without difference between them. Crural diaphragm tension (CDT) and gastroesophageal junction pressure (GEJP) significantly increased in the DBT + rabeprazole group (P < 0.05), but without change in lower esophageal sphincter (LES) pressure. There was no significant change in CDT, GEJP, and LES pressure compared with baseline in the rabeprazole group. In conclusion, long-term DBT could reduce acid suppression usage by enhancing the anti-reflux barrier, providing a non-pharmacological maintenance therapy and reducing medical costs for patients with GERD.