奥美拉唑抑酸在咽喉反流所致慢性咳嗽中的作用

The value of proton pump inhibitors(PPIs) in the treatment of chronic cough

目的:评价质子泵抑制剂奥美拉唑在慢性咳嗽治疗中的应用价值。方法:选择耳鼻咽喉头颈外科门诊就诊的慢性咳嗽患者63例,除外其他内科疾病及耳鼻咽喉科其他疾病,依据临床症状分为2组:有反酸症状组39例及无反酸症状组24例。对2组患者均予以奥美拉唑肠溶片口服,观察治疗前后的咳嗽VAS评分、反流检查计分量表(The reflux finding score,RFS)和反流症状指数量表(The reflux symptom index,RSI)评分,并对结果进行比较分析。结果:反酸症状组39例中35例(89.74%)经抑酸治疗咳嗽消失或不同程度缓解。无反酸症状组21例(退出3例)中9例(42.86%)经抑酸治疗咳嗽消失。反酸症状组治疗后2周、1个月各项评分与治疗前比较,差异均有统计学意义(P<0.05);无反酸症状组仅RSI评分项差异有统计学意义(P<0.05)。结论:慢性咳嗽有部分可归因于咽喉反流疾病,抑酸治疗有明显效果,而无反酸症状者抑酸治疗亦有一定价值。

Objective： To evaluate the value of proton pump inhibitors （PPIs） in the treatment of chronic cough. Methods： 63 outpatients with chronic cough were chosen in Otolaryngology Head and Neck Surgery of our hospital from June 2010 to August 2012, who suffered from no other medical diseases or no other diseases of Otolaryngology and who, based on clinical symptoms, were divided into two groups：the group with symptoms of acid reflux （Group A） and the group with no symptoms of acid reflux （Group B）. Both groups of patients were administered orally enteric-coated tablets of omeprazole, and then VAS score and reflux checking account subscale （The reflux finding score, RFS） and reflux symptoms index scale （The reflux symptom index, RSI） score were used to evaluate the therapeutic effects. Results：The cough disap-peared or relieved after PPIs therapy in 89.74%（35/39） patients of Group A. 3 patients in 24 cases in Group B exited in the follow-up. The cough disappeared or relieved after PPIs therapy in 42.86%（9/21） patients in Group B. Compared with those before treatment, the differences of the scores of each period of time after PPIs therapy in the patients of Group A were sta-tistically significant （P〈0.05）. Conclusion： Except the patients with chronic cough caused by medical diseases, chronic cough is partly attributed to the LPRD, and PPIs therapy has a marked effect. For the patients with no symptoms of acid re-flux therapy of chronic cough also has a certain value.