质子泵抑制剂联用西沙必利在治疗难治性支气管哮喘并胃食管反流病中的作用

目的　观察质子泵抑制剂联用西沙必利对难治性支气管哮喘并胃食管反流病的治疗作用。方法　采用随机、双盲、安慰剂对照方法,将87例难治性支气管哮喘并胃食管反流病患者分为治疗组(45例)和对照组(42例) ,治疗组在常规抗哮喘药物治疗的同时加服奥美拉唑和西沙必利,对照组加服安慰剂。记录患者的哮喘评分、胃食管反流症状持续时间,按需吸入二丙酸倍氯米松的剂量,按需吸入β2 受体激动剂的次数和测定患者的1s用力呼气容积占预计值百分比(FEV1 占预计值%) ,最大呼气容量百分比(PEF %)及PEF变异率的变化。结果　治疗后2组每天哮喘症状计分、胃食管反流症状持续时间比较有显著性差异(P <0 .0 1 ) ;治疗组按需吸入二丙酸倍氯米松的平均剂量显著减少(P <0 .0 1 ) ;按需吸入β2 受体激动剂的平均次数显著减少(P <0 .0 1 ) ;治疗后FEV1 占预计值%、PEF %及PEF变异率改善更明显(P <0 .0 1 )。结论　难治性支气管哮喘并胃食管反流病时,在抗哮喘药物进行治疗的基础上加用抗胃食管反流治疗,对难治性哮喘有明确的治疗作用。

Effect of proton pump inhibitor combined with cisapride on difficultly treating bronchial asthma with gastroesophageal reflux disease

Objective It is to observe the therapeutic effects of proton pump inhibitor combined with cisapride on difficultly treating bronchial asthma with gastroesophageal reflux disease. Methods With random, double blind and placebo control method, 87 difficultly treating bronchial asthma patients with gastroesophageal reflux disease were divided into two groups. Both groups were treated with conventional anti-asthma drugs, 45 cases in treatment group were added omeprazole and cisapride, 42 cases in control group were added placebo. Asthma scores, gastroesophageal reflux symptomatic duration, Beclomethasone dipropionate inhaled doses and β 2 receptor agonist inhaled times were recorded. The changes of forced expiratory volume in one second percentage (FEV 1%), the most expiratory volume percentage (PEF%) and PEF aberration rate were measured. Results There were significant differences in asthma scores and gastroesophageal reflux symptomatic duration between the two groups after treatment (P<0.01). Beclomethasone dipropionate inhaled average dose in treatment group decreased obviously (P<0.01), β 2 receptor agonist inhaled average times decreased obviously (P<0.01), the improvements of FEV 1%, PEF% and PEF aberration rate were more obvious (P<0.01). Conclusion On the bases therapies of anti-asthma drugs, anti-gastroesophageal reflux treatment can improve the therapeutic efficacy of difficultly treating bronchial asthma patients with gastroesophageal reflux disease.