奥美拉唑联合莫沙必利治疗慢性阻塞性肺疾病稳定期合并咽喉反流性疾病的效果分析

Effect of omeprazole combined with mosapride in the treatment of stable chronic obstructive pulmonary disease complicated with laryngopharyngeal reflux disease

目的探讨奥美拉唑联合莫沙必利治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期合并咽喉反流性疾病(laryngopharyngeal reflux disease,LPRD)的效果。方法选取2019年3月至2019年11月海口市人民医院收治的78例COPD稳定期合并LPRD患者为研究对象,依据随机数字表法将入选患者分为观察组与对照组,每组各39例。在常规COPD治疗基础上,给予观察组患者奥美拉唑联合莫沙必利治疗,给予对照组患者奥美拉唑治疗,两组患者治疗均持续8周。比较两组患者治疗前后呼吸功能[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1占用力肺活量(forced vital capacity,FVC)百分比、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)]、COPD评估测试(COPD assessment test,CAT)问卷评分、反流症状指数(reflux symptom index,RSI)评分、反流体征评分(reflux finding score,RFS)、24 h食管pH监测结果(酸反流占总时间的比例、酸反流次数、直立位与卧位的Ryan指数)、LPRD临床疗效和安全性。结果两组患者治疗后FEV1、FEV1/FVC、PaO2均显著高于本组治疗前(均P<0.05),PaCO2、CAT问卷总分、RSI评分、RFS、酸反流占总时间的比例、酸反流次数、直立位与卧位的Ryan指数均显著低于本组治疗前(均P<0.05)。观察组患者治疗后FEV1、FEV1/FVC、PaO2均显著高于对照组(均P<0.05),PaCO2、CAT问卷总分、RSI评分、RFS、酸反流占总时间的比例、酸反流次数、直立位与卧位的Ryan指数均显著低于对照组(均P<0.05)。观察组患者LPRD治疗总有效率显著高于对照组(P<0.05)。两组患者不良反应总发生率比较差异无统计学意义(P>0.05)。结论奥美拉唑联合莫沙必利能显著改善COPD稳定期合并LPRD患者的反流症状和体征,提高呼吸功能,安全有效。

Objective To investigate the effect of omeprazole combined with mosapride in the treatment of stable chronic obstructive pulmonary disease(COPD)complicated with laryngopharyngeal reflux disease(LPRD).Method Seventy-eight patients with stable COPD complicated with LPRD from March 2019 to November 2019 in Haikou People's Hospital were enrolled for the study.According to the random number table method,they were divided into observation group and control group,39 cases in each group.On the basis of conventional COPD treatment,patients in observation group were given omeprazole plus mosapride,and patients in control group were given omeprazole.The respiratory function[forced expiratory volume in one second(FEV1),the ratio of FEV1 to forced vital capacity(FVC),arterial partial pressure of oxygen(PaO2),arterial carbon dioxide partial pressure(PaCO2)],scores of COPD assessment test(CAT),reflux symptom index(RSI)score,reflux finding score(RFS),24 h esophageal pH monitoring results(the proportion of acid reflux in total time,acid reflux times,Ryan index of upright position and lying position)before and after treatment,clinical efficacy of LPRD and safety were compared between the two groups.Result After treatment,the FEV1,FEV1/FVC and PaO2 in both groups were significantly higher than those before treatment(all P<0.05),while PaCO2,total score of CAT questionnaire,RSI score,RFS,proportion of acid reflux in total time,acid reflux frequency,Ryan index of upright position and lying position were significantly lower than those before treatment(all P<0.05).After treatment,the FEV1,FEV1/FVC and PaO2 in observation group were significantly higher than those in control group(all P<0.05),while PaCO2,total score of CAT questionnaire,RSI score,RFS,proportion of acid reflux in total time,acid reflux frequency,Ryan index of upright position and lying position were significantly lower than those in control group(all P<0.05).The total effective rate of LPRD treatment in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Omeprazole combined with mosapride can significantly improve the symptoms,signs of reflux and respiratory function in patients with stable COPD complicated with LPRD,which is safe and effective.