胃食管反流与支气管哮喘之间的关系及抑酸药物对其的作用

doi:10.3877/cma.j.issn.2095-8765.2019.02.005

目的

探讨胃食管反流与支气管哮喘之间的关系及制酸药物对胃食管反流（GER）的作用分析。

方法

随机选取新疆维吾尔自治区人民医院2016年9月至2017年9月接诊的122例哮喘患者的临床资料。根据有无发生胃食管反流将本组患者分为观察组（49例）和对照组（73例）。观察组49例患者为胃食管反流合并支气管哮喘，将观察组49例患者进行随机细分，25例患者利用制酸药物（质子泵抑制剂兰索拉唑）进行治疗，24例患者选择安慰剂进行治疗。对照组73例哮喘患者未合并胃食管反流。对2组患者临床资料进行分析。对比2组患者肺功能指标等相关资料，以此探讨胃食管反流与支气管哮喘的相互关系。评价制酸药物对胃食管反流的影响。

结果

观察组45例患者肺功能各项指标明显差于对照组73例患者，差异有统计学意义（P<0.05）。制酸治疗组与安慰剂治疗组比较，差异有统计学意义（P<0.05）。

结论

支气管哮喘患者容易因各种因素发生胃食管反流，胃食管反流也容易诱发支气管哮喘，并且在发生胃食管反流后会加重哮喘患者病情会，是难治性哮喘的重要诱因。临床治疗胃食管反流患者应利用抑酸药物进行相应的抗反流治疗，效果显著，可显著改善肺功能。

关键词: 胃食管反流, 抑酸药物, 支气管哮喘, 抗反流治疗

Objective

To explore the relationship between gastroesophageal reflux and bronchial asthma and the effect of acid suppressant drug on GER.

Methods

122 cases of asthma patients received from September 2016 to September 2017 in our hospital were randomly selected into the control trial. To investigate the causes of bronchial asthma in patients with questionnaire. According to the results of the investigation, 122 patients were divided into the observation group (n=49) and the control group (n=73) on the basis of whether the gastroesophageal reflux was occurring or not. The patients in observation group (n=49) were gastroesophageal reflux with bronchial asthma, the observation group of 49 patients were randomly divided into two groups, 25 patients with acid suppressant drugs (proton pump inhibitor lansoprazole) treatment, 24 patients were treated with placebo. There were no gastroesophageal reflux in 73 patients with asthma in the control group. The retrospective analysis was used to analyze the clinical data of two groups of patients. The correlation between gastroesophageal reflux and bronchial asthma was investigated by comparing the data of two groups of 122 patients with pulmonary function. To evaluate the effect of acid suppressant drugs on gastroesophageal reflux.

Results

The pulmonary function of 45 patients in the observation group was significantly worse than that of the control group (73 cases), with significant difference (P<0.05). The therapeutic effect and lung function index of 23 patients treated with acid drugs were significantly better than those in 23 cases, with significant difference (P<0.05).

Conclusion

Bronchial asthma patients are prone to gastroesophageal reflux due to various factors. Gastroesophageal reflux is also easy to induce bronchial asthma. And after gastroesophageal reflux, asthma will aggravate, which is an important inducement of refractory asthma. The clinical treatment of gastroesophageal reflux patients should take the corresponding anti reflux treatment with the acid suppressant drugs, the effect is remarkable, it can significantly improve the lung function, the clinical promotion and extensive practice of the value.

Key words: Gastroesophageal reflux, Acid suppressant drugs, Bronchial asthma, Anti reflux therapy

表1 2组肺功能各项指标（±s）

组别	例数	FEV1（L）	FEV1/FVC	MMEF（L）	PEF（L/S）
观察组	49	2.12±0.14	69.14±3.29	2.08±0.19	4.28±0.13
对照组	73	3.01±0.22	62.03±3.34	1.71±1.21	5.23±0.09
t值	?	3.7154	7.3641	3.2514	3.2841
P值	?	0.0002	0.0000	0.0281	0.0021

表1 2组肺功能各项指标（±s）

组别	例数	FEV1（L）	FEV1/FVC	MMEF（L）	PEF（L/S）
观察组	49	2.12±0.14	69.14±3.29	2.08±0.19	4.28±0.13
对照组	73	3.01±0.22	62.03±3.34	1.71±1.21	5.23±0.09
t值	?	3.7154	7.3641	3.2514	3.2841
P值	?	0.0002	0.0000	0.0281	0.0021

表2 观察组患者不同治疗效果比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
制酸治疗组	25	16	13	1	96.00
安慰剂治疗组	24	14	6	4	83.33^a

表2 观察组患者不同治疗效果比较

组别	例数	显效（例）	有效（例）	无效（例）	总有效率（%）
制酸治疗组	25	16	13	1	96.00
安慰剂治疗组	24	14	6	4	83.33^a

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Objective to investigate the relationship between gastroesophageal reflux and bronchial asthma, and analyze the effect of acid suppressant drug on gastroesophageal reflux (GER, Geriatrics)

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Objective to investigate the relationship between gastroesophageal reflux and bronchial asthma, and analyze the effect of acid suppressant drug on gastroesophageal reflux (GER, Geriatrics)