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AIM:To compare efficacy of proton pump inhibitors(PPIs)with H2-receptor antagonists(H2RAs)plus prokinetics(Proks)for dysmotility-like symptoms in functional dyspepsia(FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od(n= 57)or famotidine 10 mg bid plus mosapride 5 mg tid(n=57)for 4 wk.The primary efficacy endpoint was change(%)from baseline in total dysmotility-like dyspepsia symptom score.The secondary efficacy endpoint was patient satisfaction with treatment.RESULTS:The improvement in dysmotility-like dyspep-sia symptom score on day 28 was significantly greater in the rabeprazole group(22.5%±29.2%of baseline) than the famotidine+mosapride group(53.2%± 58.6%of baseline,P<0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status.Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine+mosapride group(87.7%vs 59.6%,P= 0.0012).Rabeprazole therapy was the only significant predictor of treatment response(P<0.0001),defined as a total symptom score improvement≥50%.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.
AIM: To compare efficacy of proton pump inhibitors (PPIs) with H2-receptor antagonists (H2RAs) plus prokinetics (Proks) for dysmotility-like symptoms in functional dyspepsia (FD) .METHODS: Subjects were randomized to receive open label treatment with either rabeprazole 10 The primary efficacy endpoint was change (%) from baseline in total dysmotility-like dyspepsia symptom score. The secondary efficacy endpoint (n = 57) or famotidine 10 mg bid plus mosapride 5 mg tid was significantly more in the rabeprazole group (22.5% ± 29.2% of baseline) than the famotidine + mosapride group (53.2% ± 58.6% of baseline, P <0.0001). The superior benefit of rabeprazole treatment after 28 days was consistent regardless of Helicobacter pylori status. Statistically more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine + mosapride gr (87.7% vs 59.6%, P = 0.0012) .Rabeprazole therapy was the only significant predictor of treatment response (P <0.0001), defined as a total symptom score improvement≥50%. CONCLUSION: PPI monotherapy improves dysmotility-like symptoms better than H2RAs plus Proks, and should be the treatment of first choice for Japanese FD.