title: Proton pump inhibitor for non-erosive reflux disease: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy, safety and influential factors of proton pump inhibitor (PPI) treatment for non-erosive reflux disease (NERD).
  
  
  METHODS
  PubMed, MEDLINE, EMBASE and the Cochrane Library were searched up to April 2013 to identify eligible randomized controlled trials (RCTs) that probed into the efficacy, safety and influential factors of PPI treatment for NERD. The rates of symptomatic relief and adverse events were measured as the outcomes. After RCT selection, assessment and data collection, the pooled RRs and 95%CI were calculated. This meta-analysis was performed using the Stata 12.0 software (Stata Corporation, College Station, Texas, United States). The level of evidence was estimated by the Grading of Recommendations Assessment, Development and Evaluation system.
  
  
  RESULTS
  Seventeen RCTs including 6072 patients met the inclusion criteria. The results of the meta-analysis showed that PPI treatment was significantly superior to H2 receptor antagonists (H2RA) treatment (RR = 1.629, 95%CI: 1.422-1.867, P = 0.000) and placebo (RR = 1.903, 95%CI: 1.573-2.302, P = 0.000) for the symptomatic relief of NERD. However, there were no obvious differences between PPI and H2RA (RR = 0.928, 95%CI: 0.776-1.110, P = 0.414) or PPI and the placebo (RR = 1.000, 95%CI: 0.896-1.116, P = 0.997) regarding the rate of adverse events. The overall rate of symptomatic relief of PPI against NERD was 51.4% (95%CI: 0.433-0.595, P = 0.000), and relief was influenced by hiatal hernia (P = 0.030). The adverse rate of PPI against NERD was 21.0% (95%CI: 0.152-0.208, P = 0.000), and was affected by hiatal hernia (P = 0.081) and drinking (P = 0.053).
  
  
  CONCLUSIONS
  PPI overmatched H2RA on symptomatic relief rate but not on adverse rate for NERD. Its relief rate and adverse rate were influenced by hiatal hernia and drinking.
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Ji-Xiang
authors.initials: JX
authors.lastname: Zhang
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Meng-Yao
authors.initials: MY
authors.lastname: Ji
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Song
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Lei
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Qiu
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Ai
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Lv
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Zi-Rong
authors.initials: ZR
authors.lastname: Yang
authors.affiliation: Ji-Xiang Zhang, Meng-Yao Ji, Jia Song, Hong-Bo Lei, Shi Qiu, Jing Wang, Ming-Hua Ai, Jun Wang, Xiao-Guang Lv, Zi-Rong Yang, Wei-Guo Dong, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Dong
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006551:Hernia, Hiatal / Q000150:complications; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors
keywords: Adverse event; Meta-analysis; Non-erosive reflux disease; Proton pump inhibitor; Symptomatic relief