Tonny Basriyadi Sarbini
Departemen Ilmu Kesehatan Telinga, Hidung, Tenggorok, Bedah Kepala, dan Leher Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

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Perbandingan Efektivitas antara Omeprazol dan Lansoprazol terhadap Perbaikan Kualitas Hidup Penderita Rinosinusitis Kronik Akibat Refluks Laringofaring Kurniawati, Tantri; Madiadipoera, Teti; Sarbini, Tonny Basriyadi; Saifuddin, Ongka M.
Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Refluks laringofaring (RLF) adalah refluks cairan lambung melalui esofagus ke daerah laringofaring. Prevalensi RLF 15–20%, dan menjadi salah satu penyebab rinosinusitis kronik. Insidensi RLF pada penderita rinosinusitis kronik sebesar 37–72%. Prevalensi rinosinusitis kronik 16,3% pada dewasa dan berefek terhadap kualitas hidup. Omeprazol dan lansoprazol adalah proton pump inhibitor (PPI), digunakan sebagai terapi RLF, juga digunakan pada rinosinusitis kronik akibat RLF. Dilakukan penelitian periode Juni–Desember 2009. Penelitian ini merupakan randomized clinical trial dengan pengamatan open trial. Keikutsertaan 20 subjek penelitian dengan consecutive sampling, dibagi menjadi dua kelompok yang berbeda (dengan cara randomisasi sederhana) dalam pemberian PPI (omeprazol dan lansoprazol). Dilakukan pemeriksaan fisis THT, pengisian kuesioner sino-nasal outcome test 20, reflux symptom index, dan reflux finding score dengan menggunakan rinolaringoskopi serat lentur. Evaluasi setelah pemberian terapi 2 minggu dan 2 bulan. Data dianalisis dengan menggunakan uji Wilcoxon dan uji Mann-Whitney. Tidak terdapat perbedaan efektivitas antara omeprazol dan lansoprazol terhadap perbaikan derajat berat refluks laringofaring (p>0,05), namun perbaikan kualitas hidup pada kelompok perlakuan lansoprazol lebih baik bila dibandingkan dengan kelompok perlakuan omeprazol (p<0,05). Simpulan, lansoprazol lebih efektif dibandingkan dengan omeprazol dalam memperbaiki kualitas hidup pada penderita rinosinusitis kronik akibat RLF. [MKB. 2012;44(3):138–46].Kata kunci: Kualitas hidup, lansoprazol, omeprazol, refluks laringofaring, rinosinusitis kronik    Effectiveness Comparison between Omeprazole and Lansoprazole on the Improvement of Quality of Life in Patients with Chronic Rhinosinusitis Caused by Laryngopharyngeal RefluxLaryngopharyngeal reflux (LPR) is the reflux of gastric acid through the esophagus that reaches laringopharyngeal area. The prevalence of LPR in the range 15–20%, and caused chronic rhinosinusitis (CRS). The incidence of LPR in patients with CRS has ranged between 37–72%. The prevalence of CRS 16,3% in adults and affecting quality of life. Omeprazole and lansoprazole are  proton pump inhibitors (PPIs) for LPR’s therapy and also a therapy for CRS with LPR as the etiology. This research method was randomized clinical trial with open trial observation,  conducted in June to December 2009. Twenty subjects with consecutive sampling method, divided into two groups (with simple randomization), the first group received omeprazole and the other lansoprazole. The subjects conducted complete physical otolaryngology examination, sino-nasal outcome test 20, reflux symptom index and reflux finding score with fiber optic rhinolaryngoscopy. These data was obtained before therapy, after 2 weeks and  two months therapy,  analyzed with Wilcoxon’s  and Mann-Whitney’s test. There was no effectivity difference between omperazole and lansoprazole in reducing the level of severity of LPR (p>0.05), but quality of life improvement was better in lansoprazole than omeprazole group (p<0.05). In conclusion, lansoprazole is more effective than omeprazole in improvement of quality of life in patients with chronic rhinosinusitis caused by LPR. [MKB. 2012;44(3):138–46].Key words: Chronic rhinosinusitis, lansoprazole, laryngopharyngeal reflux, omeprazole, quality of life DOI: http://dx.doi.org/10.15395/mkb.v44n3.135
Efektivitas Pemberian Antibiotik Disertai Lansoprazol pada Refluks Laringofaring dengan Infeksi Helicobacter pylori Nurrokhmawati, Yanti; Madiadipoera, Teti; Anggraeni, Ratna; Sarbini, Tonny Basriyadi
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Refluks laringofaring adalah aliran balik isi lambung ke daerah laringofaring dan dapat dipengaruhi oleh infeksi Helicobacter pylori. Regimen terapi untuk infeksi H. pylori terdiri atas proton pump inhibitor (PPI) dan dua jenis antibiotik yaitu amoksisilin dan klaritromisin. Peran PPI pada regimen ini masih diteliti. Dilakukan penelitian mengenai perbandingan efektivitas terapi antibiotik disertai PPI (lansoprazol) terhadap perbaikan gejala klinis dan kualitas hidup penderita refluks laringofaring dengan infeksi H. pylori. Penelitian ini dilakukan di Departemen THT-KL RS Dr. Hasan Sadikin Bandung periode September 2009-Desember 2010 merupakan randomized clinical trial dengan pengamatan open label.Data dianalisis dengan menggunakan uji t dan uji Mann Whitney. Penelitian ini melibatkan 26 subjek penelitian yang dibagi menjadi dua kelompok. Kelompok pertama diberikan regimen terapi H. pylori, berupa klaritromisin dan amoksisilin dengan lansoprazol dan kelompok kedua diberikan klaritromisin dan amoksisilin tanpa lansoprazol. Dilakukan pemeriksaan skor gejala refluks (SGR), skor temuan refluks (STR), dan penilaian kualitas hidup dengan kuesioner reflux qual short-form (RQS). Evaluasi dilakukan setelah 2 minggu. Didapatkan perbedaan bermakna (p=0,034) skor SGR pascaterapi pada kelompok perlakuan antibiotik kombinasi dengan lansoprazol. Tidak didapatkan perbedaan bermakna (p=0,169) pada perbaikan STR pascaterapi. Perbaikan skor RQS lebih baik pada kelompok perlakuan pertama dibandingkan dengan kelompok kedua (p=0,018). Disimpulkan bahwa pemberian campuran antibiotik kombinasi dan lansoprazol lebih efektif terhadap perbaikan gejala klinis dan kualitas hidup dibandingkan dengan tanpa lansoprazol. [MKB. 2012;44(4):224–32].Kata kunci: Helicobacter pylori, kualitas hidup, lansoprazol, refluks laringofaringThe Effectiveness of Antibiotics with Lansoprazole in the Treatment of Laryngopharyngeal Reflux with Helicobacter pylori InfectionAbstractLaryngopharyngeal Reflux (LPR) is a reflux of gastric content to the laryngopharyngeal and influenced by Helicobacter pylori infection. The treatment of H. pylori infection consists of proton pump inhibitor and two kinds of antibiotics, i.e. amoxicillin and clarithromycin. The role of PPI is currently being studied. The objectives of the research were to compare the effectiveness of antibiotics regimen with and without lansoprazole in reducing the level of the severity and quality of life improvement in LPR patients with H. pylori infection. Twenty six subjects were divided into two groups; the first group received antibiotics with lansoprazole and the second group received antibiotics without lansoprazole. The research subjects were assessed using reflux symptom index (RSI) questionnaire and reflux finding score (RFS) while the assessment on the quality of life was performed using reflux qual short-form (RQS) questionnaire. These data were obtained at baseline and after 2 weeks of treatment. The method was randomized clinical trial with open label observation and the analysis was conducted using t and Mann Whitney tests. There was a significant improvement in the RSI post treatment in the first group (p=0.034). The difference in RFS was not significantly different statistically between both groups (p=0.169). The RQS was significantly better statistically in the first group (p=0.018). It is concluded that treatment regimen with claritromicin, amoxycillin and lansoprazole is more effective in the treatment of LPR associated with H. pylori infection compared to without lansoprazole. [MKB. 2012;44(4):224–32].Key words: Helicobacter pylori, laryngopharyngeal reflux, lansoprazole, quality of life DOI: http://dx.doi.org/10.15395/mkb.v44n4.215