New insights in gastroesophageal reflux, esophageal function and gastric emptying in relation to dysphagia before and after anti-reflux surgery in children. Curr Gastroenterol Rep. 2013;15:351. [PMID: 24014120 DOI: 10.1007/s11894-013-0351-3]

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated. A systematic literature search was performed from October 1, 2008 (if the question was addressed by 2009 guidelines) or from inception to June 1, 2015 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Clinical Trials. The approach of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to define and prioritize outcomes. For therapeutic questions, the quality of evidence was also assessed using GRADE. Grading the quality of evidence for other questions was performed according to the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) and Quality in Prognostic Studies (QUIPS) tools. During a 3-day consensus meeting, all recommendations were discussed and finalized. In cases where no randomized controlled trials (RCT; therapeutic questions) or diagnostic accuracy studies were available to support the recommendations, expert opinion was used. The group members voted on each recommendation, using the nominal voting technique. With this approach, recommendations regarding evaluation and management of infants and children with GERD to standardize and improve quality of care were formulated. Additionally, 2 algorithms were developed, 1 for infants <12 months of age and the other for older infants and children.

Weisu granules combined with conventional Western medicines for treatment of gastroesophageal reflux disease

AIM: To explore the clinical effects of Weisu granules combined with conventional Western medicines in the treatment of gastroesophageal reflux disease (GERD).

METHODS: Eighty-four patients with GERD were randomly divided into either an experiment group or a control group. Both the control and experiment groups were treated with conventional Western medicines, and the experiment group was additionally treated with Weisu granules. Symptom score, endoscopic score, and clinical effects were compared for the two groups.

RESULTS: Symptom score and endoscopic score were significantly lower post treatment than prior treatment in both groups (7.47 ± 2.51 vs 18.96 ± 2.88, 11.49 ± 2.35 vs 19.72 ± 2.79, 1.49 ± 0.61 vs 2.49 ± 0.62, 1.64 ± 0.63 vs 2.47 ± 0.69; P < 0.05). Symptom score and endoscopic score post treatment were significantly lower in the experiment group than in the control group (7.47 ± 2.51 vs 1.49 ± 0.61, 11.49 ± 2.35 vs 1.64 ± 0.63, P < 0.05). The clinical effects with regard to symptom improvement were better in the experiment group than in the control group (95.24% vs 80.95%, P < 0.05); there was no significant difference in clinical effects with regard to endoscopic improvement (78.57% vs 71.43%, P > 0.05).

CONCLUSION: Weisu granules combined with conventional Western medicines in GERD can improve clinical symptoms and clinical effects, and can be a treatment of choice for elderly patients with GERD.