The pathogenesis of persistent non-erosive reflux disease treated with proton-pump inhibitors as measured with the Symptom Index

Efficacy and Safety of Traditional Chinese Medicine on Nonerosive Reflux Disease: A Meta-Analysis of Randomized Controlled Trials

Objectives

Traditional Chinese medicine (TCM) therapy for nonerosive reflux disease (NERD) remains controversial. The aim of this study was to evaluate the efficacy and safety of TCM regimens in NERD treatment.

Methods

Randomized controlled trials (RCTs) of TCM treatment for NERD through September 31, 2017, were systematically identified in PubMed, Wanfang Data, CNKI, VIP, CBM, Ovid, Web of Science, and Cochrane Library databases. Quality assessment was performed by employing the Cochrane Risk of Bias assessment tool.

Results

A total of 725 and 719 patients in 14 RCTs were randomly divided into TCM alone and conventional Western medicine groups, respectively. The clinical total effective rate of the TCM group was markedly higher than that of the single proton pump inhibitors (PPIs) or Prokinetics therapy group (RR = 1.19, 95% CI = 1.07–1.31, and P = 0.0008), while it was comparable to that of the combination of PPIs and Prokinetics therapy group (RR = 1.14, 95% CI = 1.00–1.29, and P = 0.05). Compared with Western medicine group, the TCM group showed improved symptom relief through a reduced RDQ score (SMD = −0.91; 95% CI = −1.68–−0.15; and P = 0.02). Additionally, TCM clearly decreased the recurrence rate (RR = 0.38, 95% CI = 0.28–0.52, and P < 0.00001). Adverse events, such as constipation, sickness, fever, abdominal distension, and stomach noise, were slight for both the TCM and Western medicine groups and disappeared after the easement of pharmacological intervention; in particular, TCM possessed fewer side effects.

Conclusion

Compared with PPIs or Prokinetics therapy alone, TCM single therapy can better improve the clinical total effective rate and symptom relief and decrease the recurrence rate and adverse events in the treatment of NERD. Our results suggest that TCM will be a promising alternative therapy for NERD patients in the future.

Clinical effects of PDCA cycle-based nursing care in elderly gastroesophageal reflux disease patients with anxiety and depression

AIM

To observe the clinical effects of PDCA cycle-based nursing care in elderly gastroesophageal reflux disease (GERD) patients with anxiety and depression.

METHODS

Seventy-two GERD patients with anxiety and depression were selected and randomly divided into a control group and an observation group, with 36 cases in each group. Both groups received routine nursing care, and the observation group was additionally given PDCA cycle-based nursing care. The quality of life score, clinical symptom scores, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores and compliance were compared between the two groups.

RESULTS

SAS and SDS scores were significantly lower in both groups after nursing than before nursing (P < 0.05), and SAS and SDS scores were significantly lower in the observation group than the control group (P < 0.05). Clinical symptoms and quality of life scores were significantly improved in both groups after nursing (P < 0.05), and the improvement was more significant in the observation group (P < 0.05). Compared with the control group, patient compliance was significantly better in the observation group (P < 0.05).

CONCLUSION

PDCA cycle-based nursing care can improve clinical symptoms, reduce anxiety and depression, and improve patient compliance in elderly GERD patients with anxiety and depression.