Overlapping approach Proton Pump Inhibitors/Nux vomica-Heel as new intervention for gastro-esophageal reflux management:Delphi consensus study  

作　　者：Edda Battaglia Luciano Bertolusso Marco Del Prete Marco Monzani Marco Astegiano 

机构地区：[1]Gastroenterology Unit,ASLTO4,Ivrea 10015,Turin,Italy [2]General Practitioner,ASL CN2,Alba-Bra 12051,Cuneo,Italy [3]Specialist in Nephrology International Academy of Physiological Regulating Medicine,Milan 20100,Italy [4]Specialist in Endocrinology,Territorial Social and Health Authority of Brianza,Monza 20900,Italy [5]Gastroenterology Specialist,Retired from Gastroenterology and Hepatology Unit,AOU Cittàdella Salute e della Scienza,Turin 10123,Italy

出　　处：《World Journal of Gastroenterology》2024年第18期2467-2478,共12页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.

关 键 词：Gastro-esophageal reflux disease Proton Pump Inhibitors CONSENSUS Nux vomica-Heel OVERLAPPING Decalage 

分 类 号：R571[医药卫生—消化系统]