摘要
Background: Epidemiological studies have shown an association between gastro-oesophageal reflux disease (GORD) and asthma, and oesophageal acid perfusion may cause bronchial constriction. However, no causative relation has been proven. A im: To assess whether acid suppression would lead to reduced asthma symptoms in children with concomitant asthma and GORD. Methods: Thirty eight children (mean age 10.8 years, range 7.2-16.8; 29 males) with asthma and a reflux index ≥5.0 assessed by 24 hour oesophageal pH monitoring were randomised to 12 weeks of tre atment with omeprazole 20 mg daily or placebo. The groups were similar in age, g ender, mean reflux index, and asthma severity. Primary endpoints were asthma sym ptoms (daytime wheeze, symptoms at night, in the morning, and during exercise) a nd quality of life (PAQLQ). Secondary endpoints were changes in lung function an d the use of short acting bronchodilators. At the end of the study a repeated pH study was performed to confirm the efficacy of acid suppression. Results: The c hange in total symptom score did not differ significantly between the omeprazole and the placebo group, and decreased by 1.28 (95%CI -0.1 to 2.65) and 1.28 (9 5%CI -0.72 to 3.27) respectively. The PAQLQ score increased by 0.62 (95%CI 0. 29 to 0.95) in the omeprazole group compared to 0.50 (95%CI 0.29 to 0.70) in th e placebo group. Change in lung function and use of short acting bronchodilators were similar in the groups. The acid suppression was adequate (reflux index < 5 .0) under omeprazole treatment. Conclusion: Omeprazole treatment did not improve asthma symptoms or lung function in children with asthma and GORD.
Background: Epidemiological studies have shown an association between gastro-oesophageal reflux disease (GORD) and asthma, and oesophageal acid perfusion may cause bronchial constriction. However, no causative relation has been proven. A im: To assess whether acid suppression would lead to reduced asthma symptoms in children with concomitant asthma and GORD. Methods: Thirty eight children (mean age 10.8 years, range 7.2-16.8; 29 males) with asthma and a reflux index ≥5.0 assessed by 24 hour oesophageal pH monitoring were randomised to 12 weeks of tre atment with omeprazole 20 mg daily or placebo. The groups were similar in age, g ender, mean reflux index, and asthma severity. Primary endpoints were asthma sym ptoms (daytime wheeze, symptoms at night, in the morning, and during exercise) a nd quality of life (PAQLQ). Secondary endpoints were changes in lung function an d the use of short acting bronchodilators. At the end of the study a repeated pH study was performed to confirm the efficacy of acid suppression. Results: The c hange in total symptom score did not differ significantly between the omeprazole and the placebo group, and decreased by 1.28 (95%CI -0.1 to 2.65) and 1.28 (9 5%CI -0.72 to 3.27) respectively. The PAQLQ score increased by 0.62 (95%CI 0. 29 to 0.95) in the omeprazole group compared to 0.50 (95%CI 0.29 to 0.70) in th e placebo group. Change in lung function and use of short acting bronchodilators were similar in the groups. The acid suppression was adequate (reflux index < 5 .0) under omeprazole treatment. Conclusion: Omeprazole treatment did not improve asthma symptoms or lung function in children with asthma and GORD.
