Time trends of physician visits and treatment patterns of peptic ulcer disease in the United States.
Time trends of physician visits and treatment patterns of peptic ulcer disease in the United States.
复制标题
美国消化性溃疡病就诊的时间趋势和治疗模式。
DOI：
10.1001/archinte.1997.00440340131013
复制
发表时间：
1997
影响因子：
--
通讯作者：
A. Sonnenberg
中科院分区：
文献类型：
--
作者：
S. Munnangi;A. Sonnenberg
背景
在过去的40年里，消化性溃疡的患病率和我们对其病理生理特征的认识发生了重大变化。
客观化
分析这些趋势如何影响医生就诊和溃疡疾病的治疗。
方法
以宾夕法尼亚州普利茅斯会议的IMS America Ltd的国家疾病和治疗指数作为数据源。调查数据是在48小时内每年从具有代表性的美国医生样本中获得4次，并外推到全国水平。胃、十二指肠和所有消化性溃疡的就诊率以每10万美国人的就诊率表示。
结果
从1958年到1995年，十二指肠溃疡的就诊人数明显下降，而胃溃疡的就诊人数基本保持不变。1995年，有400万患者因消化性溃疡就诊，相当于每10万美国人口中有1500人就诊。从1958年到1977年，主要的治疗方法从抗胆碱类药物、镇静剂和抗酸剂转变为组胺2受体拮抗剂，从1978年到1988年，组胺2受体拮抗剂后来被硫糖铝和质子泵抑制剂部分取代。1995年，大约75%的溃疡仍主要用抗分泌药物治疗，只有5%接受抗生素治疗。
结论
消化性溃疡仍然很常见，尽管十二指肠溃疡的发病率在继续下降。治疗方案的历史趋势表明，不同的药物之间存在稳定的变化。在20多年的时间里，溃疡治疗中没有一个治疗班占据主导地位。这一趋势可能会继续下去，特别是考虑到目前有一小部分人正在接受抗生素治疗，以根除幽门螺杆菌。
BACKGROUND
In the last 4 decades, the prevalence rates of peptic ulcer disease and our understanding of its pathophysiological features underwent major changes.
OBJECTIVE
To analyze how these trends affected physician visits and treatment of ulcer disease.
METHODS
The National Diseases and Therapeutic Index of IMS America Ltd, Plymouth Meeting, Pa, was used as the data source. Survey data were obtained from a representative sample of US physicians 4 times per year during a 48-hour period and extrapolated to a national level. Physician visits for gastric, duodenal, and all peptic ulcers were expressed as rates per 100,000 living US population.
RESULTS
Between 1958 and 1995, physician visits for duodenal ulcer showed a marked decline, while those for gastric ulcer remained largely unchanged. In 1995, 4 million patients visited a physician because of peptic ulcer, corresponding to a rate of 1500 per 100,000 US population. The predominant therapy changed from anticholinergics, tranquilizers, and antacids between 1958 and 1977 to histamine2 receptor antagonist from 1978 until 1988, which subsequently became replaced in part by sucralfate and proton pump inhibitors. In 1995, about 75% of ulcers were still treated primarily with antisecretory medications, and only 5% received antibiotic therapy.
CONCLUSIONS
Peptic ulcer is still common, although duodenal ulcer rates continue to decrease. The historical trends of treatment regimens show a steady change between various medications. No therapeutic class dominated ulcer therapy for more than 20 years. This trend is likely to continue, particularly, in light of the small fraction currently treated by antibiotics to eradicate Helicobacter pylori.
影响因子：
2.9
作者：
Kurata,JH;Corboy,ED
通讯作者：
Corboy,ED
影响因子：
2.1
作者：
Sellman,S;Blanchard,TG;Nedrud,JG;Czinn,SJ
通讯作者：
Czinn,SJ
溃疡病时间趋势的重新评估：与溃疡住院和死亡率变化相关的因素。
影响因子：
12.7
作者：
Kurata,JH;Elashoff,JD;Haile,BM;Honda,GD
通讯作者：
Honda,GD