沙美特罗替卡松粉吸入剂联合埃索美拉唑镁肠溶片及莫沙必利治疗哮喘并发胃食管反流病的临床效果观察

账目的观察沙美特罗替卡松粉吸入剂联合埃索美拉唑镁肠溶片及莫沙必利治疗哮喘并发胃食管反流病（GERD）的疗效。方法选取浙江省海宁市第二人民医院100例哮喘并发GERD患者进行前瞻性双盲随机对照试验，采用完全随机分组方法将患者分为观察组及对照组，各50例。观察组给常规平喘（沙美特罗替卡松粉吸入剂）治疗，1吸／次、2次／d，加抗食管反流抑酸药埃索美拉唑镁肠溶片20mg／次、1次／d及胃动力药莫沙必利5mg／次、3次／d；对照组仅按常规给沙美特罗替卡松粉吸入剂药物，1吸／次、2次／d。2组均治疗4周，对2组疗效进行对比分析。结果观察组有效率达92．0％（46／50），对照组有效率44．0％（22／50），2组比较差异有统计学意义（P〈0．01）；观察组第1秒用力呼气容积（FEV1）治疗前为（2．50±0．15）L，治疗后为（2．73±0．18）L，用力肺活量（FVC）治疗前为（3．19±0．16）L，治疗后为（3．39±0．20）L，差异有统计学意义（P〈0．01）；对照组治疗前FEV1及FVC分别为（2．55±0．16）L、（3．18±0．16）L，治疗后二者分别为（2．65±0．15）L、（3．20±0．15）L，2组治疗后的肺功能（包括FEV1、FVC）比较差异有统计学意义（P〈0．01）。结论哮喘并发GERD的治疗，单纯应用平喘药不能达到效果，加用抗食管反流抑酸药物及胃动力药可提高疗效。

Effect of treatment of asthma complicated by gastroesophageal reflux disease with seretide combined esomeprazole and mosapride

Objective To observe the effectiveness of the treatment of asthma complicated with gastroesophageal reflux disease （GERD） by seretide combined esomeprazole and mosapride. Methods This was a prospective randomized controlled trial. One hundred patients with asthma complicated by GERD were randomly divided into a treatment group （group A） and the control group （group B）. Group A were treated by conventional antiasthmatic （seretide） therapy combined with anti-esophageal reflux acid-suppressing drug （esomeprazole） and motility drug （mosapride）. Group B were only treated by conventional antiasthmatic （seretide）. The effects of treatment were analysis between groups. Results The effective rate of observation group was 92.0% （46/50） and the effective rate was 44.0% （22/50） in the control group; the difference was statistically significant （P 〈 0.01 ）. Observation group lung function （including forced expiratory volume in one second and forward voice channel） was significandy improved after treatment （P 〈 0.01 ）; the observation group and control group had statistically significant differences in pulmonary function after treatment （P 〈 0. 01 ）. Conclusion Concurrent treatment of GERD asthma, asthma medication plus anti-reflux acid-suppressing drugs and motility drugs can increase the effective rate.