老年胃食管反流病合并哮喘临床研究

Clinical observation of gastroesophageal reflux disease(GERD) combined with asthma in geriatric patients

目的探讨老年胃食管反流病(GERD)合并哮喘患者的临床特征,为临床诊断治疗提供帮助。方法收集江苏省老年医学研究所2007年1月至2011年12月就诊的83例老年GERD合并哮喘患者临床资料,在常规哮喘治疗基础上均给予口服埃索美拉唑(40mg,1次/d)联合枸橼酸莫沙必利(5mg,3次/d)抗反流治疗8周,之后埃索美拉唑(20mg,1次/d)联合枸橼酸莫沙必利(5mg,每日临睡前)维持治疗。结合2007年胃食管反流病治疗共识意见与2008年支气管哮喘防治指南哮喘控制水平分级标准来观察疗效。结果 83例患者经抗反流治疗8周后,胃食管反流症状控制有效率为97.6%(81/83),哮喘控制有效率为94.0%(78/83)。其中完全停用哮喘治疗药物56例、用量减半20例、继续原用药7例。随访5年,哮喘完全控制70例,仍偶有哮喘发作13例,但发作次数减少、程度减轻。无药物不良反应。结论抗反流治疗可以改善老年GERD合并哮喘患者的症状,提高生活质量。

Objective To analyze clinical characteristics of GERD combined with asthma in elderly patients for improvement of diagnosis and treatement. Methods The clinical data of 83 elderly GERD patients combined with asthma who had been admitted into Jiangsu Province Geriatric Institute from January 2007 to December 2011 were collected. On the basis of the conventional treatment for asthma, these patients received esomeprazole 40 mg daily and mosapride citrate 5 mg three times per day for 8 weeks.After that,esomeprazole 20 mg and mosapride citrate 5 mg daily were prescribed to the patients for sustained therapy. The effect and safety of anti-reflux therapy were evaluated. Results After eight-week treatment with esomeprazole and mosapride citrate, the total effective rate of GERD symptoms was 97.6%(81/83), and the total effective rate of asthma was 94.0%(78/83).Asthma-control medication was stopped in 56 patients, reduced to 1/2 in 20 patients and continued in 7 patients.During follow-up,70 patients benefited from the treatment with complete asthma control and seldom attack of asthma was seen in 13 patients with reduced frequency and severity.There were no obvious side effects. Conclusions The symptoms of GERD combined with asthma in elderly patients can be improved by anti-reflux durgs.