Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease
Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease
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DOI：
10.1111/j.1365-2036.2006.03213.x
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发表时间：
2007-02-15
影响因子：
7.6
通讯作者：
Vakil, N.
中科院分区：
文献类型：
--
作者：
Gatta, L.;Vaira, D.;Vakil, N.
背景许多研究者提出胃食管反流病和咽喉症状之间存在联系，提示内科或外科治疗反流可能是有用的。目的进行荟萃分析，评估内科或外科治疗反流疾病的有效性，成人患者的喉或咽症状被认为是由于胃-方法通过检索MEDLINE，确定比较胃食管反流病药物或手术治疗与安慰剂的随机对照试验（1966- 2005年9月）、EMBASE（1974- 2005年9月）、CCRCT（至2005年9月）和胃肠病学和耳鼻喉科会议摘要。采用随机效应模型（random-effectsmodel.Results）评价了5篇使用大剂量质子泵抑制剂干预的研究的相对风险。没有手术研究符合纳入标准。合并相对危险度为1.18（95%置信区间：0.81-1.74）。研究之间没有异质性，但有证据表明存在显著的出版偏倚。亚组分析进行评估Jadad评分和症状类型，并没有改变相对risk.Conclusions治疗与高剂量质子泵抑制剂是没有更有效的比安慰剂在生产症状改善或解决咽喉症状。需要进一步研究以确定可能对质子泵抑制剂治疗有反应的患者的特征。
Background Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful.Aim To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease.Methods Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966-September 2005), EMBASE (1974-September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model.Results Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81-1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk.Conclusions Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.