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首页> 外文期刊>Annals of the New York Academy of Sciences >Pharmacologic treatment of GERD: Where we are now, and where are we going?
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Pharmacologic treatment of GERD: Where we are now, and where are we going?

机译：GERD的药理治疗：我们现在在哪里，我们要去哪里？

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The introduction of acid inhibition in clinical practice has revolutionized the management of acid-related diseases, leading to the virtual abolition of elective surgery for ulcer disease and relegating antireflux surgery to patients with gastroesophageal reflux disease (GERD) not adequately managed by medical therapy. Proton pump inhibitors (PPIs) are the antisecretory drugs of choice for the treatment of reflux disease. However, these drugs still leave some unmet clinical needs in GERD. PPI-refractoriness is common, and persistent symptoms are observed in up to 40-55% of daily PPI users. Potassium-competitive acid blockers (P-CABs) clearly overcome many of the drawbacks and limitations of PPIs, achieving rapid, potent, and prolonged acid suppression, offering the opportunity to address many of the unmet needs. In recent years, it has been increasingly recognized that impaired mucosal integrity is involved in the pathogenesis of GERD. As a consequence, esophageal mucosal protection has emerged as a new, promising therapeutic avenue. When P-CABS are used as add-on medications to standard treatment, a growing body of evidence suggests a significant additional benefit, especially in the relief of symptoms not responding to PPI therapy. On the contrary, reflux inhibitors are considered a promise unfulfilled, and prokinetic agents should only be used on a case-by-case basis.
机译：临床实践中酸性抑制的引入彻底改变了酸相关疾病的管理，导致溃疡病的视情滥用选择性手术，并将抗缺陷手术降排在胃食管反流疾病（GERD）的患者不受医学治疗。质子泵抑制剂（PPI）是用于治疗回流疾病的防盗药物。然而，这些药物仍然在GERD中留下了一些未满足的临床需求。 PPI-REARENTELINES是常见的，并且持续症状高达40-55％的每日PPI用户。竞争力的酸性阻滞剂（P-Cabs）清楚地克服了PPI的许多缺点和局限性，实现了快速，有效和延长的酸抑制，提供了解决许多未满足需求的机会。近年来，越来越认识到，粘膜完整性受损涉及GERD发病机制。因此，食管粘膜保护已成为一种新的，有前途的治疗大道。当P-Cabs用作标准治疗的加载药物时，越来越大的证据表明了显着的额外效益，特别是在不响应PPI治疗的症状的缓解中。相反，回流抑制剂被认为是未实现的承诺，并且仅在案例基础上使用动力药剂。

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