抑酸剂联合促胃动力药治疗稳定期COPD合并胃食管反流的效果

Effect of proton pump inhibitor combined with gastric motility drugs in the treatment of stable COPD complicated with gastroesophageal reflux

目的观察抑酸剂联合促胃动力药治疗稳定期慢性阻塞性肺疾病(COPD)合并胃食管反流病(GERD)患者的效果。方法选取2015年3月~2016年3月我院门诊复诊的90例稳定期COPD合并GERD患者作为研究对象,按就诊先后顺序依次纳入对照组及干预组。两组均不改变原有COPD治疗方案,干预组加用奥美拉唑胶囊(20 mg,2次/d)及莫沙必利分散片(5 mg,3次/d),治疗周期为8周。比较两组治疗前后的胃食管反流评分(RDQ)、圣乔治呼吸问卷(SGRQ)评分、肺功能FEV1占预计值百分比(FEV_1% pred)、6 min步行距离(6MWD)。结果与对照组比较,干预组治疗后的RDQ评分显著降低,SGRQ各部分分值及总分显著降低,差异有统计学意义(P<0.05);FEV_1% pred、6MWD无显著变化,差异无统计学意义(P>0.05)。干预组治疗前后的RDQ评分与FEV_1% pred、6MWD成负相关,与SGRQ各部分分值及总分成正相关(P<0.05)。结论抑酸剂联合促胃动力药物可改善COPD合并GERD患者的临床症状,提高生活质量。

Objective To observe the effects of proton pump inhibitor （PPI） combined with gastric motility drugs in the treatment of stable chronic obstructive pulmonary disease （COPD） and gastroesophageal reflux disease （GERD）.Meth- ods 90 outpatients with stable COPD and GERD in our hospital from March 2015 to March 2016 were selected and di- vided into the control group and the intervention group respectively according to the order of treatment.The original treatment about COPD was not changed for both groups and the intervention group was treated with Omeprazole （20 mg, po bid） and Mosapride （5 mg,po tid） for 8 weeks additionally.The reflux diagnostic questionnaire （RDQ） score,St George＇s respiratory questionnaire （SGRQ） score,lung function （FEV1% pred） and 6 minute walk distance （6MWD） were com- pared between the two groups before and after treatment.Results Compared with the control group,the RDQ score,each part and the total score of SGRQ in intervention group after treatment was significant lower （P〈0.05）,while FEV1% pred and 6MWD had no significant change （P〉0.05）.The RDQ score was negatively correlated with FEV1% pred and 6MWD before and after treatment in the two groups,while positively correlated with the score of SGRQ （P〈0,05）.Conclusion Treatment with PPI combined with gastric motility drugs can improve clinical symptoms and life quality of patients with COPD coexisting with GERD.