奥美拉唑和甲氧氯普胺对成人哮喘伴胃食管返流患者的疗效

Effect of Anti-gastro Esophageal Reflux(GER) Therapy with Omeprazole and Metoclopramide in Asthmatics with Gastro Esophageal Reflux

目的研究联合奥美拉唑和甲氧氯普胺抗胃食管反流治疗对哮喘症状控制的临床疗效。方法将142例哮喘伴胃食管反流患者随机分为两组,均采用常规抗哮喘治疗,治疗组加用奥美拉唑20mg,每天2次,甲氧氯普胺5mg,每日4次,为期8周。在用药开始前和治疗8周后分别行肺功能检查。结果治疗组与对照组比较,白天哮喘症状评分改善(18.0%∶7.9%)、夜间哮喘症状评分改善(19.0%∶12.0%)、反流症状评分改善(34.8%∶7.2%)、沙丁胺醇的使用次数减少(34.6%∶25.5%)。两者比较均有显著差别(P<0.005)。白天和夜间最大呼气流量(PEFR)值分别为(21.1%∶11.5%)、(13.9%∶10.7%),1秒用力呼气量(FEV1)值(10.1%∶6.1%),用力肺活量(FVC)(11.8%∶6.1%),治疗组比安慰剂有显著改善(P<0.01)。结论奥美拉唑和甲氧氯普胺联合治疗成人哮喘伴胃食管反流,可减轻哮喘症状,减少β2激动剂药物的使用,改善肺功能。

Objective To evaluate the effect of anti-gastro esophageal reflux（GER） therapy with omeprazole and metoclopramide in asthmatics with gastro esophageal reflux.Methods 142 asthmatics with GER were randomly divided into two groups.All the patients were treated with the anti-asthma drugs for 8 weeks and the therapy group took omeprazole at dose of 40 mg 2 times a day,metoclopramide 5mg 4 times a day.Spirometry was done at begin and after 8wk of treatment.Results Comparison of mean change between antireflux therapy and control groups revealed significant reduction in daytime asthma symptom score（18.0%∶7.9%）,nighttime asthma symptom score（19.0%∶12.0%）,reflux symptom score（34.8%∶7.2%） and albuterol use（34.6%∶25.5%）（all the P〈0.005）.There was significant improvement in morning PEFR（21.1%∶11.5%）,evening PEFR（13.9%∶10.7%）,FEV1（10.1%∶6.1%） and FVC（11.8%∶6.1%） in the antireflux therapy group compared to control group（P〈0.01）.Conclusion Combined therapy with omeprazole and metoclopramide in adult asthmatics with gastro esophageal reflux may be reducing asthma symptoms,rescuing medication use,and improving pulmonary function.