胃食管反流病的非药物治疗现状与新进展
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摘要
胃食管反流病(GERD)是一种常见的上消化道疾病,约40%GERD患者经药物规范治疗后疗效不佳,根据患者的具体情况针对性的治疗方法显得愈发重要,积极探索一些非药物治疗手段成为近年来GERD相关研究的热点。本文通过总结回顾5年国内外的文献,比较各种非药物治疗的优缺点,包括生活方式的调整,穴位刺激,膈肌生物反馈,内镜下治疗,外科手术等非药物治疗方法进展做一综述。
Gastroesopheal reflux disease(GERD) is a common upper gastrointestinal disease but around 40% GERD patients had poor symptom control under standard drug treatment, Therefore actively exploring some nonpharmacological therapy for GERD has become a research hotspot in recent years in this paper, The recent research of GERD especially in the past five years has been analyzed to compare the advantages and disadvantages of the various nonpharmacological therapy and clarify the selection of it. we reviewed the progression in study on treatment of GERD, such as lifestyle change acupoint stimulation,diaphragm biofeedback, endoscopic treatment and surgery.
Gastroesopheal reflux disease(GERD) is a common upper gastrointestinal disease but around 40% GERD patients had poor symptom control under standard drug treatment, Therefore actively exploring some nonpharmacological therapy for GERD has become a research hotspot in recent years in this paper, The recent research of GERD especially in the past five years has been analyzed to compare the advantages and disadvantages of the various nonpharmacological therapy and clarify the selection of it. we reviewed the progression in study on treatment of GERD, such as lifestyle change acupoint stimulation,diaphragm biofeedback, endoscopic treatment and surgery.
引文
1 Gyawali CP,Kahrilas PJ,Savarino E,et al.Modern diagnosis of GERD:the Lyon Consensus[J].Gut,2018,67(7):1351-1362.
2 Fock KM,Talley N,Goh KL,et al.Asia-Pacific consensus on the management of gastro-oesophageal reflux disease:an update focusing on refractory reflux disease and Barrett's oesophagus[J].Gut,2016,65(9):1402-1415.
3陈旻湖,侯晓华,肖英莲,等.2014年中国胃食管反流病专家共识意见[J].胃肠病学,2015,20(3):155-168.
4 Sethi S,Richter JE.Diet and gastroesophageal reflux disease:role in pathogenesis and management[J].Curr Opin Gastroenterol,2017,33(2):107-111.
5 Allampati S,Lopez R,Thota PN,et al.Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms[J].Dis Esophagus,2017,30(3):1-7.
6 Efendieva MT.[The experience with the application of nonmedicamental methods for the treatment of the patients presenting with gastroesophageal reflux disease][J].Vopr Kurortol Fizioter Lech Fiz Kult,2013,(6):31-35.
7 Kessing BF,Bredenoord AJ,Saleh CM,et al.Effects of anxiety and depression in patients with gastroesophageal reflux disease[J].Clin Gastroenterol Hepatol,2015,13(6):1089-1095 e1081.
8 Zhang L,Tu L,Chen J,et al.Psychological distress as a crucial determinant for quality of life in patients with noncardiac chest pain in Central China:A cross-sectional study[J].Medicine(Baltimore),2016,95(46):e5289.
9 Zhang L,Tu L,Chen J,et al.Health-related quality of life in gastroesophageal reflux patients with noncardiac chest pain:Emphasis on the role of psychological distress[J].World J Gastroenterol,2017,23(1):127-134.
10 Botha C,Farmer AD,Nilsson M,et al.Preliminary report:modulation of parasympathetic nervous system tone influences oesophageal pain hypersensitivity[J].Gut,2015,64(4):611-617.
11李军祥,陈誩,李岩.胃食管反流病中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(3):221-226+232.
12 Shuai X,Xie P,Liu J,et al.Different effects of electroacupuncture on esophageal motility and serum hormones in cats with esophagitis[J].Dis Esophagus,2008,21(2):170-175.
13 Yin J,Chen JD.Gastrointestinal motility disorders and acupuncture[J].Auton Neurosci,2010,157(1-2):31-37.
14 Dickman R,Schiff E,Holland A,et al.Clinical trial:acupuncture vs.doubling the proton pump inhibitor dose in refractory heartburn[J].Aliment Pharmacol Ther,2007,26(10):1333-1344.
15 Han G,Leem J,Lee H,et al.Electroacupuncture to treat gastroesophageal reflux disease:study protocol for a randomized controlled trial[J].Trials,2016,17(1):246.
16 Efendieva MT.[Efficacy of acupuncture in the treatment of patients with gastroesophageal reflux disease][J].Eksp Klin Gastroenterol,2013,(5):49-52.
17 Chen SP,Kan Y,Zhang JL,et al.Involvement of hippocampal acetylcholinergic receptors in electroacupuncture analgesia in neuropathic pain rats[J].Behav Brain Funct,2016,12(1):13.
18 Horrocks EJ,Thin N,Thaha MA,et al.Systematic review of tibial nerve stimulation to treat faecal incontinence[J].Br J Surg,2014,101(5):457-468.
19 Iqbal F,Collins B,Thomas GP,et al.Bilateral transcutaneous tibial nerve stimulation for chronic constipation[J].Colorectal Dis,2016,18(2):173-178.
20吴玲玲,林征,林琳,等.经皮神经电刺激治疗对胃食管反流病病人临床症状改善及生活质量的影响[J].护理研究,2015,29(31):3868-3871.
21 Banerjee R,Pratap N,Kalpala R,et al.Effect of electrical stimulation of the lower esophageal sphincter using endoscopically implanted temporary stimulation leads in patients with reflux disease[J].Surg Endosc,2014,28(3):1003-1009.
22 Rodriguez L,Rodriguez P,Gomez B,et al.Two-year results of intermittent electrical stimulation of the lower esophageal sphincter treatment of gastroesophageal reflux disease[J].Surgery,2015,157(3):556-567.
23 Rodriguez L,Rodriguez PA,Gomez B,et al.Electrical stimulation therapy of the lower esophageal sphincter is successful in treating GERD:long-term 3-year results[J].Surg Endosc,2016,30(7):2666-2672.
24 Auyang ED,Carter P,Rauth T,et al.SAGES clinical spotlight review:endoluminal treatments for gastroesophageal reflux disease(GERD)[J].Surg Endosc,2013,27(8):2658-2672.
25 Liang WT,Wang ZG,Wang F,et al.Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure:a prospective observational study[J].BMC Gastroenterol,2014,14:178.
26 Fass R,Cahn F,Scotti DJ,et al.Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease[J].Surg Endosc,2017,31(12):4865-4882.
27 Hakansson B,Montgomery M,Cadiere GB,et al.Randomised clinical trial:transoral incisionless fundoplication vs.sham intervention to control chronic GERD[J].Aliment Pharmacol Ther,2015,42(11-12):1261-1270.
28 Trad KS,Barnes WE,Simoni G,et al.Transoral incisionless fundoplication effective in eliminating GERD symptoms in partial responders to proton pump inhibitor therapy at 6 months:the TEMPORandomized Clinical Trial[J].Surg Innov,2015,22(1):26-40.
29 Trad KS,Simoni G,Barnes WE,et al.Efficacy of transoral fundoplication for treatment of chronic gastroesophageal reflux disease incompletely controlled with high-dose proton-pump inhibitors therapy:a randomized,multicenter,open label,crossover study[J].BMC Gastroenterol,2014,14:174.
30 Testoni PA,Testoni S,Mazzoleni G,et al.Long-term efficacy of transoral incisionless fundoplication with Esophyx(Tif 2.0)and factors affecting outcomes in GERD patients followed for up to 6years:a prospective single-center study[J].Surg Endosc,2015,29(9):2770-2780.
31 Ganz RA,Fallon E,Wittchow T,et al.A new injectable agent for the treatment of GERD:results of the Durasphere pilot trial[J].Gastrointest Endosc,2009,69(2):318-323.
32 Gad El-Hak N,Mostafa M,Hamdy E,et al.Short and long-term results of laparoscopic total fundic wrap(Nissen)or semifundoplication(Toupet)for gastroesophageal reflux disease[J].Hepatogastroenterology,2014,61(135):1961-1970.
33 Asti E,Siboni S,Lazzari V,et al.Removal of the Magnetic Sphincter Augmentation Device:Surgical Technique and Results of a Singlecenter Cohort Study[J].Ann Surg,2017,265(5):941-945.
34 Warren HF,Reynolds JL,Lipham JC,et al.Multi-institutional outcomes using magnetic sphincter augmentation versus Nissen fundoplication for chronic gastroesophageal reflux disease[J].Surg Endosc,2016,30(8):3289-3296.
2 Fock KM,Talley N,Goh KL,et al.Asia-Pacific consensus on the management of gastro-oesophageal reflux disease:an update focusing on refractory reflux disease and Barrett's oesophagus[J].Gut,2016,65(9):1402-1415.
3陈旻湖,侯晓华,肖英莲,等.2014年中国胃食管反流病专家共识意见[J].胃肠病学,2015,20(3):155-168.
4 Sethi S,Richter JE.Diet and gastroesophageal reflux disease:role in pathogenesis and management[J].Curr Opin Gastroenterol,2017,33(2):107-111.
5 Allampati S,Lopez R,Thota PN,et al.Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms[J].Dis Esophagus,2017,30(3):1-7.
6 Efendieva MT.[The experience with the application of nonmedicamental methods for the treatment of the patients presenting with gastroesophageal reflux disease][J].Vopr Kurortol Fizioter Lech Fiz Kult,2013,(6):31-35.
7 Kessing BF,Bredenoord AJ,Saleh CM,et al.Effects of anxiety and depression in patients with gastroesophageal reflux disease[J].Clin Gastroenterol Hepatol,2015,13(6):1089-1095 e1081.
8 Zhang L,Tu L,Chen J,et al.Psychological distress as a crucial determinant for quality of life in patients with noncardiac chest pain in Central China:A cross-sectional study[J].Medicine(Baltimore),2016,95(46):e5289.
9 Zhang L,Tu L,Chen J,et al.Health-related quality of life in gastroesophageal reflux patients with noncardiac chest pain:Emphasis on the role of psychological distress[J].World J Gastroenterol,2017,23(1):127-134.
10 Botha C,Farmer AD,Nilsson M,et al.Preliminary report:modulation of parasympathetic nervous system tone influences oesophageal pain hypersensitivity[J].Gut,2015,64(4):611-617.
11李军祥,陈誩,李岩.胃食管反流病中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(3):221-226+232.
12 Shuai X,Xie P,Liu J,et al.Different effects of electroacupuncture on esophageal motility and serum hormones in cats with esophagitis[J].Dis Esophagus,2008,21(2):170-175.
13 Yin J,Chen JD.Gastrointestinal motility disorders and acupuncture[J].Auton Neurosci,2010,157(1-2):31-37.
14 Dickman R,Schiff E,Holland A,et al.Clinical trial:acupuncture vs.doubling the proton pump inhibitor dose in refractory heartburn[J].Aliment Pharmacol Ther,2007,26(10):1333-1344.
15 Han G,Leem J,Lee H,et al.Electroacupuncture to treat gastroesophageal reflux disease:study protocol for a randomized controlled trial[J].Trials,2016,17(1):246.
16 Efendieva MT.[Efficacy of acupuncture in the treatment of patients with gastroesophageal reflux disease][J].Eksp Klin Gastroenterol,2013,(5):49-52.
17 Chen SP,Kan Y,Zhang JL,et al.Involvement of hippocampal acetylcholinergic receptors in electroacupuncture analgesia in neuropathic pain rats[J].Behav Brain Funct,2016,12(1):13.
18 Horrocks EJ,Thin N,Thaha MA,et al.Systematic review of tibial nerve stimulation to treat faecal incontinence[J].Br J Surg,2014,101(5):457-468.
19 Iqbal F,Collins B,Thomas GP,et al.Bilateral transcutaneous tibial nerve stimulation for chronic constipation[J].Colorectal Dis,2016,18(2):173-178.
20吴玲玲,林征,林琳,等.经皮神经电刺激治疗对胃食管反流病病人临床症状改善及生活质量的影响[J].护理研究,2015,29(31):3868-3871.
21 Banerjee R,Pratap N,Kalpala R,et al.Effect of electrical stimulation of the lower esophageal sphincter using endoscopically implanted temporary stimulation leads in patients with reflux disease[J].Surg Endosc,2014,28(3):1003-1009.
22 Rodriguez L,Rodriguez P,Gomez B,et al.Two-year results of intermittent electrical stimulation of the lower esophageal sphincter treatment of gastroesophageal reflux disease[J].Surgery,2015,157(3):556-567.
23 Rodriguez L,Rodriguez PA,Gomez B,et al.Electrical stimulation therapy of the lower esophageal sphincter is successful in treating GERD:long-term 3-year results[J].Surg Endosc,2016,30(7):2666-2672.
24 Auyang ED,Carter P,Rauth T,et al.SAGES clinical spotlight review:endoluminal treatments for gastroesophageal reflux disease(GERD)[J].Surg Endosc,2013,27(8):2658-2672.
25 Liang WT,Wang ZG,Wang F,et al.Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure:a prospective observational study[J].BMC Gastroenterol,2014,14:178.
26 Fass R,Cahn F,Scotti DJ,et al.Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease[J].Surg Endosc,2017,31(12):4865-4882.
27 Hakansson B,Montgomery M,Cadiere GB,et al.Randomised clinical trial:transoral incisionless fundoplication vs.sham intervention to control chronic GERD[J].Aliment Pharmacol Ther,2015,42(11-12):1261-1270.
28 Trad KS,Barnes WE,Simoni G,et al.Transoral incisionless fundoplication effective in eliminating GERD symptoms in partial responders to proton pump inhibitor therapy at 6 months:the TEMPORandomized Clinical Trial[J].Surg Innov,2015,22(1):26-40.
29 Trad KS,Simoni G,Barnes WE,et al.Efficacy of transoral fundoplication for treatment of chronic gastroesophageal reflux disease incompletely controlled with high-dose proton-pump inhibitors therapy:a randomized,multicenter,open label,crossover study[J].BMC Gastroenterol,2014,14:174.
30 Testoni PA,Testoni S,Mazzoleni G,et al.Long-term efficacy of transoral incisionless fundoplication with Esophyx(Tif 2.0)and factors affecting outcomes in GERD patients followed for up to 6years:a prospective single-center study[J].Surg Endosc,2015,29(9):2770-2780.
31 Ganz RA,Fallon E,Wittchow T,et al.A new injectable agent for the treatment of GERD:results of the Durasphere pilot trial[J].Gastrointest Endosc,2009,69(2):318-323.
32 Gad El-Hak N,Mostafa M,Hamdy E,et al.Short and long-term results of laparoscopic total fundic wrap(Nissen)or semifundoplication(Toupet)for gastroesophageal reflux disease[J].Hepatogastroenterology,2014,61(135):1961-1970.
33 Asti E,Siboni S,Lazzari V,et al.Removal of the Magnetic Sphincter Augmentation Device:Surgical Technique and Results of a Singlecenter Cohort Study[J].Ann Surg,2017,265(5):941-945.
34 Warren HF,Reynolds JL,Lipham JC,et al.Multi-institutional outcomes using magnetic sphincter augmentation versus Nissen fundoplication for chronic gastroesophageal reflux disease[J].Surg Endosc,2016,30(8):3289-3296.