{"title":"症状-反流关联对异常胃酸反流患者二次治疗结果的临床价值","authors":"Satsuki Takahashi, Tomoaki Matsumura, Michiko Sonoda, Tomomi Ozaki, Tatsuya Kaneko, Ryosuke Horio, Chihiro Goto, Akane Kurosugi, Yuki Ohta, Takashi Taida, Atsuko Kikuchi, Kenichiro Okimoto, Jun Kato","doi":"10.1159/000547213","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Multichannel intraluminal impedance and pH monitoring (MII-pH) is the gold standard for diagnosing gastroesophageal reflux disease (GERD). However, the clinical value of the symptom-reflux association (SRA) obtained using MII-pH remains unknown. The current study aimed to investigate the effect of SRA on the efficacy of secondary treatment in refractory true GERD.</p><p><strong>Methods: </strong>This study included patients who underwent MII-pH monitoring for evaluating proton pump inhibitor (PPI)- or potassium-competitive acid blocker (P-CAB)-refractory GERD symptoms and who were diagnosed with abnormal acid reflux (acid exposure time >6%). Patients with a positive symptom index (SI) and symptom association probability on the MII-pH monitoring were included in the SRA-positive group and the remaining ones in the SRA-negative group. The differences in the subsequent treatment efficacy between the two groups were retrospectively analyzed. Treatment efficacy was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire.</p><p><strong>Results: </strong>Of the 192 patients with PPI-/P-CAB-refractory GERD, 41 (21.4%) were diagnosed with abnormal acid reflux. Among them, 30 (7 in the SRA-positive group and 23 in the SRA-negative group) underwent symptom assessments before and after treatment. The SRA-positive group had a significantly greater symptom improvement after treatment compared with the SRA-negative group (FSSG score changes: -13.0 ± 6.5 vs. -5.4 ± 8.2, p = 0.016).</p><p><strong>Conclusions: </strong>SRA evaluation is effective in predicting secondary treatment outcomes in patients with abnormal acid reflux.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.6000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Value of the Symptom-Reflux Association on Secondary Treatment Outcomes in Patients with Abnormal Acid Reflux.\",\"authors\":\"Satsuki Takahashi, Tomoaki Matsumura, Michiko Sonoda, Tomomi Ozaki, Tatsuya Kaneko, Ryosuke Horio, Chihiro Goto, Akane Kurosugi, Yuki Ohta, Takashi Taida, Atsuko Kikuchi, Kenichiro Okimoto, Jun Kato\",\"doi\":\"10.1159/000547213\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Multichannel intraluminal impedance and pH monitoring (MII-pH) is the gold standard for diagnosing gastroesophageal reflux disease (GERD). However, the clinical value of the symptom-reflux association (SRA) obtained using MII-pH remains unknown. The current study aimed to investigate the effect of SRA on the efficacy of secondary treatment in refractory true GERD.</p><p><strong>Methods: </strong>This study included patients who underwent MII-pH monitoring for evaluating proton pump inhibitor (PPI)- or potassium-competitive acid blocker (P-CAB)-refractory GERD symptoms and who were diagnosed with abnormal acid reflux (acid exposure time >6%). Patients with a positive symptom index (SI) and symptom association probability on the MII-pH monitoring were included in the SRA-positive group and the remaining ones in the SRA-negative group. The differences in the subsequent treatment efficacy between the two groups were retrospectively analyzed. Treatment efficacy was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire.</p><p><strong>Results: </strong>Of the 192 patients with PPI-/P-CAB-refractory GERD, 41 (21.4%) were diagnosed with abnormal acid reflux. Among them, 30 (7 in the SRA-positive group and 23 in the SRA-negative group) underwent symptom assessments before and after treatment. The SRA-positive group had a significantly greater symptom improvement after treatment compared with the SRA-negative group (FSSG score changes: -13.0 ± 6.5 vs. -5.4 ± 8.2, p = 0.016).</p><p><strong>Conclusions: </strong>SRA evaluation is effective in predicting secondary treatment outcomes in patients with abnormal acid reflux.</p>\",\"PeriodicalId\":11315,\"journal\":{\"name\":\"Digestion\",\"volume\":\" \",\"pages\":\"1-10\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000547213\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547213","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
多通道腔内阻抗和pH监测（MII-pH）是诊断胃食管反流病（GERD）的金标准。然而，使用MII-pH获得的症状-反流关联（SRA）的临床价值尚不清楚。本研究旨在探讨SRA对难治性真胃食管反流二次治疗疗效的影响。方法：本研究纳入了接受MII-pH监测以评估质子泵抑制剂（PPI）或钾竞争酸阻滞剂（P-CAB）难耐GERD症状并被诊断为异常酸反流（酸暴露时间bbb6%）的患者。MII-pH监测症状指数（SI）和症状关联概率（SAP）均为阳性的患者为sra阳性组，其余患者为sra阴性组。回顾性分析两组患者后续治疗疗效的差异。采用胃食管反流症状频率量表（FSSG）问卷评估治疗效果。结果：在192例PPI / pcab难治性胃食管反流患者中，41例（21.4%）诊断为异常胃酸反流。其中30例（sra阳性组7例，sra阴性组23例）在治疗前后进行了症状评估。sra阳性组治疗后症状改善明显高于sra阴性组（FSSG评分变化：-13.0±6.5 vs -5.4±8.2,p = 0.016）。结论：SRA评价可有效预测异常胃酸反流患者的二次治疗结果。
Clinical Value of the Symptom-Reflux Association on Secondary Treatment Outcomes in Patients with Abnormal Acid Reflux.
Introduction: Multichannel intraluminal impedance and pH monitoring (MII-pH) is the gold standard for diagnosing gastroesophageal reflux disease (GERD). However, the clinical value of the symptom-reflux association (SRA) obtained using MII-pH remains unknown. The current study aimed to investigate the effect of SRA on the efficacy of secondary treatment in refractory true GERD.
Methods: This study included patients who underwent MII-pH monitoring for evaluating proton pump inhibitor (PPI)- or potassium-competitive acid blocker (P-CAB)-refractory GERD symptoms and who were diagnosed with abnormal acid reflux (acid exposure time >6%). Patients with a positive symptom index (SI) and symptom association probability on the MII-pH monitoring were included in the SRA-positive group and the remaining ones in the SRA-negative group. The differences in the subsequent treatment efficacy between the two groups were retrospectively analyzed. Treatment efficacy was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire.
Results: Of the 192 patients with PPI-/P-CAB-refractory GERD, 41 (21.4%) were diagnosed with abnormal acid reflux. Among them, 30 (7 in the SRA-positive group and 23 in the SRA-negative group) underwent symptom assessments before and after treatment. The SRA-positive group had a significantly greater symptom improvement after treatment compared with the SRA-negative group (FSSG score changes: -13.0 ± 6.5 vs. -5.4 ± 8.2, p = 0.016).
Conclusions: SRA evaluation is effective in predicting secondary treatment outcomes in patients with abnormal acid reflux.
期刊介绍：
''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.
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