慢性咳嗽与咽喉反流的相关探讨

目的探讨慢性咳嗽与咽喉反流(Laryngopharyngeal reflux LPR)的关系,以达到提高治疗疾病的效果。方法对118例诊断为慢性咳嗽患者进行详细询问病史、食管钡餐检查、间接喉镜、纤维喉镜、电子胃镜等相关检查,发现其中37例慢性咳嗽患者存在或疑似有咽喉反流。随机分为两组,治疗组:应用质子泵抑制剂(埃索美拉唑40mg/d),胃肠促动力药(莫沙必利5mg,3次/d)治疗,对照组:应用H2受体阻滞剂(法莫替丁20mg,2次/d),胃肠促动力药(莫沙必利5mg,3次/d),对两组的咳嗽及咽喉部症状缓解及喉镜胃镜下病理改善情况进行统计学比较。结果检出LPR37例(31.4%),治疗组19例,有效率92.0%(18例),对照组18例,有效率66.7%(12例),P<0.05。结论 LPR是导致慢性咳嗽的重要病因,抑酸剂与促动力药联合使用,可缓解或改善咽喉反流的症状和病理。

Objective Chronic cough and gastroesophageal reflux（Laryngopharyngeal reflux LPR） relationships to achieve greater therapeutic effect.Methods 118 patients with hospital diagnosis of chronic cough patients history in detail,esophageal barium meal examination,indirect laryngoscopy,fiber optic laryngoscopy and other related electronic gastroscope examination found 37 cases of patients with chronic cough with throat or suspected anti-flow.Randomly divided into treatment groups：Application of proton pump inhibitors（esomeprazole 40mg/d）,gastrointestinal prokinetic agent（mosapride 5mg,3times/d） treatment,control group：application of H2 by Body blockers（famotidine 20mg,2times/d）,gastrointestinal prokinetic agent（mosapride 5mg,3 times/d）,the two groups of cough and throat symptoms and endoscopic laryngoscopy under pathological improvement were statistically compared.Results The detection LPR 37 cases（31.4%）,treatment group 19 cases,efficiency 92.0%（18 cases）,control group 18 cases,with 66.7%（12 cases）,P 0.05.Conclusion LPR is leading an important cause of chronic cough,acid suppression and prokinetic agents in combination,can alleviate or improve symptoms of gastroesophageal reflux and pathological