Selective Serotonin Reuptake Inhibitors In Treating Gastroesophageal Reflux Disease : A Meta-analysis

Background Gastro-esophageal reflux disease(GERD) is a very common chronic diseases of the digestive tract, its incidence increase year by year. GERD not only cause serious damage to people’s health, but also has a significant impact on people’s psychological. Most of the patients with esophageal high sensitivity and anxiety, depression, mental state, which makes the treatment failed in GERD patients,these problem are often faced by digestive department doctors. Current diagnosis of GERD has not yet reached a consensus. Selective serotonin reuptake inhibitors(SSRIs) is a new kind of anxiety, depression drug. It has been as the auxiliary drugs to treatment GERD in the research at home or abroad and has obtained the good curative effect.Objective To assess the efficacy of SSRIs in the treatment of gastro-esophageal reflux disease(GERD).Methods According the retrieval strategy,the inclusion criteria and exclusion criteria, all randomized controlled trials(RCTs) in English or in Chinese about SSRIs(include Sertraline、 Fluoxetine 、Paroxetine 、Citalopram 、Fluvoxamine)for GERD were searched from Chinese science and technology journal full-text database、 Wan-fang data 、 Chinese national knowledge internet( CNKI)、 VIP Chinese Scientific、Pubmed、Ovid、EMBASE、Web of Science and Cochrane Database. The methodologic quality of the included trials was evaluated using the Jadad score,and the feature information in the studies were extracted. The selected trails were then calculated by the software Rev Man5.0.Heterogeneity test level a = 0.1, statistic utilize RR and 95% CI, and the effect of test level = 0.05.Results 430 articles were searched and 7 RCT articles met the criteria were selected for this meta-analysis.735 GERD patients was included in the 7 RCTs.The experimental group(add with SSRIs),a total of 369 cases,in the control group(conventional therapy),a total of 366 cases.Heterogeneity inspection: X2 = 5.43, P = 0.49, it shows that the effect between volume is homogeneous, the fixed effects model is adopted. The efficient of the experimental group was obviously higher than that of control group.The differences are statistically significant. At random to remove any articles of the 7 papers and then Meta analysis by fixed effects model, the result is statistically significant,it shows statistical results are in good stability.regard the RR values as abscissa, SE(log RR)as the ordinate map funnel, and the left leg of funnel chart is missing, so publication bias exists.The adverse reaction rate of SSRIs to treatment of GERD compare with tradition methods,RR = 1.40(95% CI: 0.66, 2.95), P > 0.05, no statistical significance, it means add SSRIs to treat GERD would not significantly increase the adverse reaction.Conclusion This meta-analysis provides an evidence that SSRIs for GERD is effective. Adverse events associated with SSRIs are mildly.