抗反流治疗联合噻托溴铵对慢性阻塞性肺病伴胃食管反流病的临床疗效  

Clinical efficacy of antireflux therapy combined with tiotropium bromide in COPD patients with GERD

作　　者：孙志芬 张媚霞 曲桂红 兰风金 李敏 孙树华 

机构地区：[1]沧州和平医院内科,河北省沧州市061000

出　　处：《世界华人消化杂志》2016年第9期1412-1416,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨抗反流治疗联合噻托溴铵对伴有胃食管反流的慢性阻塞性肺病(chonic obstructive pulmonary disease,COPD)患者的临床疗效.方法:选取2014-01/2014-12在沧州和平医院就诊的48例COPD合并胃食管反流病(gastroesophageal reflux disease,GERD)患者作为研究对象,随机分为观察组和对照组,各24例,观察组给予埃索美拉唑、莫沙必利及噻托溴铵粉吸入剂治疗,对照组单纯给予噻托溴铵粉吸入剂治疗,比较两组患者治疗前后胃食管反流病评分量表(Gastroesophageal Reflux Disease-Q,GERD-Q)评分、慢性阻塞性肺病急性发作(AECOPD)次数以及临床疗效.结果:两组患者治疗1年后,GERD-Q评分:观察组明显下降(9.83±2.65 vs 15.23±3.75,P<0.001),对照组下降不显著(13.32±3.02 vs 14.98±3.64,P>0.05);两组患者AECOPD次数较治疗前均下降:观察组(1.08±0.30 vs 1.59±0.34),对照组(1.33±0.31 vs 1.60±0.41).而观察组较对照组下降更明显(1.08±0.30 vs 1.33±0.31,P<0.01);临床疗效:两组COPD症状改善比较(91.6%vs 87.50%,P>0.05),观察组GERD症状显著优于对照组(95.83%vs 66.67%,P<0.01).结论:临床中对稳定期COPD合并GEGD患者给予抗反流治疗联合噻托溴铵是可行的,可有效改善GERD-Q评分、降低AECOPD次数、临床疗效显著.AIM： To investigate the clinical efficacy of anti-reflux therapy combined with tiotropium bromide in chronic obstructive pulmonary disease（COPD） patients with gastroesophageal reflux disease（GERD）.METHODS： Forty-eight GERD patients who were treated at our hospital from January 2014 to December 2014 were included and randomly divided into either an observation group or a control group, with 24 patients in each group. The observation group was given esomeprazole, mosapride and tiotropium bromide, and the control group was only given tiotropium bromide. GERD-Q score, number of acute episodes of COPD and clinical efficacy were compared between the two groups. R E S U LT S ： After 1 year of treatment, GERD-Q score significantly decreased in the observation group（15.23 ± 3.75 vs 9.83 ± 2.65, P 0.001）, but showed no significant decrease in the control group（14.98 ± 3.64 vs 13.32 ± 3.02, P 0.05）; the number of acute episodes of COPD significantly decreased in both the observation group（1.59 ± 0.34 vs 1.08 ± 0.30） and control group（1.60 ± 0.41 vs 1.33 ± 0.31）, and the decrease was more significant in the than observation group than in the control group（1.08 ± 0.30 vs 1.33 ± 0.31, P 0.01）; and the rate of COPD symptom improvement showed no significant difference between the two groups（91.6% vs 87.50%, P 0.05）, but the rate of GERD symptom improvement was better in the observation group（95.83% vs66.67%, P 0.01）.CONCLUSION： Anti-reflux treatment combined with tiotropium bromide for COPD patients with GERD is feasible, and it can effectively improve GERD-Q score, decrease the number of acute episodes of COPD and has a significant curative effect.

关 键 词：慢性阻塞性肺疾病 胃食管反流病 抗反流治疗 噻托溴铵 

分 类 号：R563.9[医药卫生—呼吸系统] R571[医药卫生—内科学]