埃索美拉唑治疗反流性咳嗽的疗效分析

Clinical effect of esomeprazole on gastroesophageal reflux induced cough

目的观察食道反流与慢性咳嗽的关系以及埃索美拉唑对慢性反流性咳嗽的疗效。方法对200例慢性咳嗽患者进行24小时食管pH监测,其中82例被诊断为食道反流性咳嗽,观察这82例患者咳嗽症状与食道反流的关系,同时将这82例患者随机分为两组,其中41例患者作为实验组给予埃索美拉唑进行为期8周的抗反流治疗,另41例患者给予同样疗程的莫沙比利治疗,并对结果加以分析。24小时食管pH监测包括反流参数即反流次数、反流时间大于5分钟的次数、最长反流时间、ph<4的时间占监测时间的百分比及Demeester总积分。结果无论实验组还是对照组24小时食道pH值均无显著性差异,但是进行抗酸治疗后两组的结果有显著性差异,实验组的24小时食道pH值与对照组相比有显著降低(P<0.05),实验组的咳嗽症状较对照组也有明显改善(P<0.05)。结论24小时食道pH监测对于食道反流引起的慢性咳嗽具有重要的诊断意义,而且抗酸治疗对于食道反流性咳嗽的症状改善也具有作用。

Objective To Object the symptom correlation between gastroesophageal reflux and chronic cough, study the effect of esomeprazole on gastroesophageal reflux induced cough（GER）. Methods 24 hour Esophageal pH mo- nitoring were performed in 200 patients who had the chronic clinical symptom（≥8 weeks）. There are 82 cases that had the clinical symptom of chronic cough were diagnosed as patients with gastroesophageal reflux. The 82 cases with gas- troesophageal reflux induced cough （GER） were choosed to observe relationship between the clinical symptom of chronic cough and gastroesophageal reflux. In the meantime,the patients were randomly divided into two groups. As experiment group, 41 of them were treated with esomeprazole for 8 weeks and 41 patients treated by mosapride who served as control group, and was given results. The date from 24 hour pH inspection include all the parameters of esophageal acid reflux such as episodes of acid reflux, number of the reflux longer than 5 min, the longest reflux time （min）, percentage time of pH〈4, Demeester score. Results 24 hour pH inspection results of the experiment did not have notable difference, whether the experiment group or control group （P〉0.05）. But there was significant difference between the two groups after anti reflux therapy （P〈0.05）. 24 hour Esophageal pH of cough in the experiment group was significantly lower than that in control （P〈0.05） and the clinic symptom were improved significantly also associated with the experiment group. Conclusion The GERD patients with cough have more esophageal acid exposure than other patients with chronic cough, 24 hour esophageal pH monitoring was of great value in diagnosing GER in patients with chronic cough and it suggested anti reflux therapy was effective in improving symptoms of cough induced by GER.