χ 2 Wilcoxon signed rank test paired t FD SF-36 BP GH VT MH MCS H. pylori H. pylori

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1 Vol. 30, pp , 2002 Helicobacter pylori QOL Helicobacter pylori H. pylori FD H. pylori QOL HRQOL HRQOL SF-36 HRQOL GSRS H. pylori FD H. pylori 3 2 SF-36 8 GSRS χ 2 Wilcoxon signed rank test paired t H. pylori SF-36 PF PCS FD SF-36 BP GH VT MH MCS H. pylori FD HRQOL Helicobacter pylori QOL Helicobacter pylori H. pylori 1 H. pylori 2 functional dyspepsia: FD H. pylori 3~10 quality of life QOL 11~ H. pylori 23

2 Table 1 Clinical Characteristics of Patients with Peptic Ulcer and Functional Dyspepsia QOL health related QOL: HRQOL HRQOL HRQOL HRQOL HRQOL HRQOL Medical Outcomes Study 36-Item Short-Form Health Survey SF-36 HRQOL Gastrointestinal Symptom Rating Scale GSRS QOL HRQOL SF-36 GSRS 14 SF-36 GSRS H. pylori FD H. pylori HRQOL H. pylori FD 59 H. pylori ± FD ± H. pylori HRQOL SF-36 GSRS ± FD ± Table 1 FD Rome II criteria functional gastrointestinal disorders gastroduodenal disorders functional dyspepsia FD H. pylori H. pylori Grade A SF-36 GSRS informed consent 2 3 Gastrointestinal Symptom Rating Scale GSRS GSRS gastro-esophageal reflux: GER ulcer like dysmotility diarrhea constipation 5 HRQOL GSRS H. 24

3 H. pylori QOL pylori HRQOL. Medical Outcomes Study 36-Item Short-Form Health Survey SF-36 SF physical functioning: PFrole-physical: RP body pain: BP general health: GH vitality: VT social functioning: SFrole-emotional: RE mental health: MH 8 QOL physical component summary: PCS mental component summary: MCS SF-36 Version H. pylori HRQOL SF-36 Version 1.2 SF-36 Ver SF-36 SF-36 TM version1 scoring program v.1.00 SF-36 TM version1.2 v lansoprazole 60 mg amoxicillin 1,500 mg clarithromycin 400 mg LAC lansoprazole 60 mg amoxicillin 1,500 mg metronidazole 1,000 mg LAM LAM informed consent H. pylori 1 H. pylori Table 2 Eradication Rate. Stat View version 5.0 SAS Institute Inc. GSRS Wilcoxon signed rank test SF-36 paired t-test χ 2 test. FD 52 LAC LAM Table 2 LAC 78.8% 41/ % 26/ % 17/ % 9/12 FD 71.4% 15/21 LAM 100% 11/11 3 HRQOL 52 GSRS Table 3 SF-36 Table 4 GSRS H. pylori % H. pylori 25

4 Table 3 Central Trend Statistics for GSRS Scales Table 4 Central Trend Statistics for Eight Dimensions of SF-36 Reference Values % % 2 H. pylori % % 2 H. pylori % SF-36 H. pylori RP BP GH VT SF RE MH MCS PF PCS RP BP GH VT SF RE MH MCS H. pylori H. pylori PF PCS H. pylori FD FD ulcer-like dyspepsia 57.1% 12/21 dysmotility-like dyspepsia 42.9% 9/21 ulcerlike dyspepsia GSRS H. pylori % H. pylori % % 2 H. pylori % 2 H. pylori SF-36 H. pylori BP GH VT MH MCS PF RP SF RE 26

5 H. pylori QOL PCS BP GH VT RE MH MCS H. pylori BP VT RE MH H. pylori GH MCS PF RP SF PCS H. pylori HRQOL HRQOL DIGEST study % HRQOL Psychological General Well-Being Index PGWBI HRQOL 23 HRQOL 24 H. pylori 11~13 14 H. pylori HRQOL HRQOL H. pylori FD H. pylori 2 25 GSRS SF-36 BP H. pylori gastro-esophageal reflux GER H. pylori GERD GERD 26~31 GER H. pylori 32~34 GER ~39 20% H. pylori 3 4 H. pylori H. pylori H. pylori HRQOL SF-36 HRQOL Wilhelmsen Psychosocial Adjustment to Illness Scale PAIS 40 H. pylori PAIS psychological distress HRQOL 27

6 SF-36 H. pylori BP RP RE MH VT SF HRQOL PF H. pylori PF activity of daily life ADL ADL H. pylori MCS H. pylori HRQOL PCS H. pylori HRQOL H. pylori HRQOL Ruta 27 HRQOL SF-36 BP RP SF VT RE MH GH 41 HRQOL H. pylori H. pylori H. pylori H. pylori HRQOL FD FD functional gastrointestinal disorders Rome II criteria gastroduodenal disorders non ulcer dyspepsia NUD GER FD ulcer-like dyspepsia dysmotility-like dyspepsia 18 GER 35~39 NUD 3 ulcer-like U dysmotility D GER R U D R U + D + R 38 3 FD H. pylori H. pylori 3~10 ulcer-like dyspepsia H. pylori FD H. pylori H. pylori H. pylori H. pylori FD H. pylori H. pylori H. pylori FD H. pylori HRQOL FD H. pylori FD 28

7 H. pylori QOL FD H. pylori HRQOL SF-36 H. pylori PF RP RE MH FD HRQOL FD FD FD HRQOL MCS H. pylori PCS H. pylori FD HRQOL FD 13% H. pylori FD H. pylori FD 1 H. pylori FD FD H. pylori HRQOL HRQOL SF-36 HRQOL GSRS Helicobacter pylori HRQOL 1 HRQOL H. pylori HRQOL 2 FD HRQOL H. pylori HRQOL. 1 Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, Sasaki N and Schlemper RJ. Helicobacter pylori infection and the development of gastric cancer. New England Journal of Medicine 2001; 345: ,..,,,,, 1999: ,. NUD Helicobacter pylori. Helicobacter Research 2001; 5: ,. NUD Helicobacter pylori. Helicobacter Research 2001; 5: ,. NUD Helicobacter pylori. Progress in Medicine 2000; 21: ,,,,,. Helicobacter pylori : H. pylori. Helicobacter Research 2000; 4: ,,. NUD H. pylori. 1998; 26: ,. H. pylori NUD. 2001; 8: ,,,,,. Non ulcer dyspepsia H. pylori. 2000; 31: ,,,,,. Non ulcer dyspepsia H. pylori. 2000; 31: ,,. NUD. Helicobacter Research 2001; 5: ,,,. NUD. Helicobacter Research 2001; 5:

8 13, ; 2: ,,,. QOL.,, ,, Green J. QOL GSRS QOL. 1999; 87: QOL QOL QOL. 1997; 13: QOL. 1999; 46: The functional gastrointestinal disorders and Rome II process. Gut 1999; 45: II1-II NUD. Helicobacter Research 2001; 5: ,,,. SF-36 (Ver. 1.2). ( ),, Eggleston A, Farup C and Meier R. The Domestic/ International Gastroenterology Surveillance Study (DIGEST): Design, Subjects and Methods. Scandinavian Journal of Gastroenterology 1999; 231: Stanghelini V. Three-month prevalence rates of gastrointestinal symotoms and the influence of demographic factors: Results from the Domestic/ International Gastroenterology Surveillance Study (DIGEST). Scandinavian Journal of Gastroenterology 1999; 231: Enck P, Dubois D and Marquis P. Quality of life in patients with upper gastrointestinal symptoms: Results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scandinavian Journal of Gastroenterology 1999; 231: Glise H, Hallerback B and Johansson B. Quality of life assessments in evaluation of laparoscopic Rosetti fundoplication. Surg Endosc 1995; 9: ,. ( ).,,, 18.4,,, 1999: GERD. Helicobacter Research 2001; 5: ,,. GERD H. pylori. Helicobacter Research 2001; 5: ,. GERD ( ). Helicobacter Research 2001; 5: ,. Helicobacter pylori. Helicobacter Research 2001; 5: ,,. Helicobacter pylori. Helicobacter Research 2001; 5: ,,,,. H. pylori GERD H. Pylori. Helicobacter Research 2001; 5: H. pylori GERD H. pylori. Helicobacter Research 2001; 5: Dore MP, Leandro G and Idda M. Cure Helicobacter pylori infection may cure symptomatic gastrooesophageal reflux disease. Gut 2000; A83. 34,. Helicobacter pylori GERD. Helicobacter Research 2001; 5: NUD. Helicobacter Research 2001; 5: Talley NJ, Silverstein MD, Agreus L, Nyren O, Sonnenberg A and Holtmann G. AGA Technical review evaluation of dyspepsia. Gastroenterology 1998; 114: Non-ulcer-dyspepsia. 1992; 89: ,,,. non-ulcer-dyspepsia. 1993; 21: Inoue M, Sekiguchi T, Hasgawa S, Miwa T and Miyoshi A. Dyspepsia and dyspepsia subgroups in Japan. Scandinavian Journal of Gastroenterology 1993; 26: Wilhelmsen I. Quality of life and Helicobacter pylori eradication. Scandinavian Journal of Gastroenterology 1996; 221: Ruta DA, Garratt AM and Russell IT. Patient centred assessment of quality of life for patient with four common conditions. Quality in Health Care 1999; 8: ,. Helicobacter pylori. Helicobacter Research 2000; 4:

9 H. pylori QOL 43,,. Helicobacter pylori 3. Helicobacter Research 2000; 46: NUD ; 33: ,,,,,. Helicobacter pylori ph. Helicobacter Research 2001; 5: ,,,. NUD H. pylori. Therapeutic Research 2001: 22: ,. Helicobacter pylori. 2001; 3: ,,. NUD. 1996; 11: Abstract The Effect of Helicobacter pylori Eradication Therapy on Health Related QOL Toshiaki Suzuki 1, Hiroki Sugimori 2, Chisato Hamashima 2, Makoto Suga 3, Hirohito Kawaguchi 1, and Toshio Nakamura 1 The effect of Helicobacter pylori (H. pylori) eradication on health related QOL (HRQOL) in patients with H. pylori positive peptic ulcer or functional dyspepsia (FD) was examined using SF-36, a generic scale for measuring HRQOL, and GSRS, a specific scale for measuring HRQOL in digestive system disorders. The subjects of the study were patients with peptic ulcer or FD, who received H. pylori eradication therapy between April 1, 2001, and March 31, 2002 at the outpatient of the Gastroenterology and Hepatology unit in St. Marianna University's Yokohama City Seibu Hospital. We were able to obtain response to our questionnaire before and after the H. pylori eradication procedure from 52 patients out of the 55 who gave consent to the treatment. The questionnaire was given twice, on the day the patient gave consent to receiving the H. pylori eradication therapy and 3 months after the therapy. With SF-36, the differential scores of the 8 dimensions and the differential scores of the physical and mental summary scores obtained from the first questionnaire were compared with those obtained from the second questionnaire, and with GSRS, the symptom scores of the upper digestive tract such as gastro-esphogeal reflux, stomachache, and dysmotility of the digestive tract obtained from the first questionnaire, were compared with those from the second questionnaire. In the group with peptic ulcer, significant improvement was seen in the subjective symptoms and in all of the scores of SF-36 excluding physical functioning (PF) and physical component summary (PCS). In the group with FD, significant improvement was seen in stomachache as well as in role physical (RP), body pain (BP), general health (GH), vitality (VT), mental health (MH) and mental component summary (MCS) of SF-36. The H. pylori eradication therapy improved the HRQOL in patients with peptic ulcer or FD. (St. Marianna Med. J., 30: , 2002) 1 Division of General Internal Medicine, Department of Internal Medicine 2 Department of Preventive Medicine St. Marianna University School of Medicine, Sugao, Miyamae-ku, Kawasaki , Japan 3 Suga Medical Clinic 31

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