摘要
胃食管反流病(GERD)是最常见的消化系统疾病之一,其发病率高、临床症状表现复杂、难以进行标准治疗、医疗负担重。目前不同国家和学术组织发表了GERD的相关指南,在指导临床实践的同时,也存在部分推荐意见不一致的情况,给当前GERD的临床全病程管理造成一定的困扰。本文总结GERD指南中的相关证据并制定其全病程管理策略,为临床实践提供科学依据。首先,检索专业指南网站、相关学会网站以及电子数据库,纳入2010年以后发表或更新的GERD指南,从症状、流行病学、诊断以及治疗等方面提取并整合推荐意见,最终以证据图的形式呈现其管理流程。本文纳入24篇指南,其中中文3篇,英文21篇,从GERD临床症状表现、诊断方法、内科治疗、抗反流手术及内镜治疗、心理支持治疗、中医治疗等多方面进行了证据汇总,概括并图示了其临床实践管理流程。
Gastroesophageal reflux disease(GERD)is one of the most common digestive diseases with high incidence,complicated clinical symptoms,difficulties in standard treatment,and heavy medical burden.At present,some GERD-relevant clinical practice guidelines(CPGs)have been issued by different countries and academic organizations,but some recommendations were inconsistent,which has caused some problems for the current clinical whole-course management of GERD.To summarize the relevant evidence among the CPGs on GERD and formulate the wholecourse management strategies,we included GERD-relevant CPGs published or updated after 2010 by searching websites of guidelines,relevant professional societies,and electronic databases.We extracted the recommendations and summarized the evidence from the aspects of symptoms,epidemiology,diagnosis and treatment,which was presented in the form of evidence mapping.We included 24 CPGs,including three in Chinese and 21 in English.The clinical practice management strategies of GERD were formulated based on the evidence from the aspects of clinical symptoms,diagnostic methods,medical treatment,anti-reflux surgery and endoscopic treatment,psychological treatment,and traditional Chinese medicine treatment.
作者
张馨予
杨珂璐
刘小南
俞德梁
李睿姝
姜可伟
王权
Zhang Xinyu;Yang Kelu;Liu Xiaonan;Yu Deliang;Li Ruishu;Jiang Kewei;Wang Quan(Ambulatory Surgery Center,Xijing Hospital,Air Force Military Medical University,Xi'an 710032,China;Academic Center for Nursing and Midwifery,Department of Public Health and Primary Care,University of Leuven(KU Leuven),Leuven 3000,Belgium;Department of Gastroenterological Surgery,Peking University People's Hospital,Beijing 100044,China)
出处
《中华胃肠外科杂志》
CSCD
北大核心
2023年第4期389-395,共7页
Chinese Journal of Gastrointestinal Surgery
基金
陕西省重点研发计划(2022ZDLSF04⁃04)
空军军医大学西京医院学科助推计划(XJZT21CM27)。
关键词
胃食管反流
疾病管理
指南
循证医学
证据图
Gastroesophageal reflux
Disease management
Guidebook
Evidencebased medicine
Evidence mapping
