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首页> 外文期刊>World Journal of Gastroenterology >Comparison between empirical pro kinetics, Helicobacter test- and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study
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Comparison between empirical pro kinetics, Helicobacter test- and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

机译：患有消化不良的初级保健患者的经验动力学，幽门螺杆菌治疗和经验内窥镜检查的比较：一项为期一年的研究

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AIM: To investigate the optimal strategy to treat dyspeptic patients in primary care. METHODS: Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to: (1) empirical endoscopy, (2) H pylori test-and-treat, and (3) empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life (SF-36) as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year. RESULTS: Two hundred and thirty four patients were recruited (163 female, mean age 49). 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK$4343, $1771 and $1750 per patient. 66% of the patients preferred to have early endoscopy. CONCLUSION: The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option.
机译：目的：探讨在初级保健中治疗消化不良患者的最佳策略。方法：将在初级保健门诊就诊的消化不良患者随机分为：（1）经验内窥镜检查，（2）H幽门螺杆菌检测和治疗，以及（3）西沙必利的经验性运动治疗。如果患者在2周后仍保持症状，则安排早期内镜检查。评估症状严重程度，生活质量（SF-36）以及患者的喜好和满意度。所有患者均于第6周接受内窥镜检查。患者随访一年。结果：招募了234名患者（163名女性，平均年龄49岁）。 46％的幽门螺杆菌阳性。在第2周的随访中，有26％的H幽门螺杆菌和25％的经验代动力学患者没有改善，需要早期内镜检查。接受西沙必利经验治疗的患者中有15％对治疗反应良好，但消化性溃疡是最终诊断。各组之间的症状缓解和生活质量相似。三种策略的费用分别为每位患者4343港元，1771美元和1750美元。 66％的患者更喜欢早期内镜检查。结论：这三种策略是同等有效的。经验性的运动疗法治疗是最便宜的，但这种治疗可能会遗漏消化性溃疡。幽门螺杆菌测试和治疗是最具成本效益的选择。

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