腹式深呼吸训练配合莫沙必利及奥美拉唑治疗对胃食管反流病并慢性阻塞性肺疾病肺功能和吞咽功能的影响  

Effects of abdominal deep breathing training combined with mosapride and omeprazole on the lung function and swallowing function of patients with gastroesophageal reflux disease complicated with COPD

作　　者：石海燕[1] 李昌平 谭礼让 李虎[1] 黄丽华[1] 罗朝晖[1] SHI Haiyan;LI Changping;TAN Lirang;LI Hu;HUANG Lihua;LUO Zhaohui(Digestive System Department,Bazhong Central Hospital,Bazhong,Sichuan 636000,China;Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]巴中市中心医院消化内科,四川巴中636000 [2]西南医科大学,四川泸州646000

出　　处：《安徽医药》2023年第8期1641-1645,共5页Anhui Medical and Pharmaceutical Journal

基　　金：四川省医学科研青年创新课题(Q17001)。

摘　　要：目的探讨腹式深呼吸训练(ADBT)配合莫沙必利及奥美拉唑治疗对胃食管反流病(GERD)合并慢性阻塞性肺疾病(COPD)病人肺功能和吞咽功能的影响。方法选取2019年7月至2020年6月巴中市中心医院收治的GERD合并COPD病人88例,按随机数字表法分为对照组(n=44,予莫沙必利与奥美拉唑)与观察组(n=44,在对照组基础上联合ADBT)。比较两组反流性疾病问卷(RDQ)评分、圣乔治呼吸问卷(SGRQ)评分、肺功能[肺活量(FVC)、第1秒用力呼气容量(FEV1)、最大吸气压(MIP)、最大呼气压(MEP)]、吞咽功能、括约肌功能、随访1年COPD急性加重发作率。结果治疗后两组RDQ评分、SGRQ评分、上段食管括约肌(UES)静息压均低于治疗前(P<0.05),且治疗后观察组RDQ评分[(13.39±4.01)分比(19.28±4.93)分]、SGRQ评分[(118.08±18.22)分比(137.59±15.77)分]、UES静息压[(40.72±4.49)mmHg比(52.96±5.49)mmHg]均低于对照组(P<0.05)。治疗后两组FVC、FEV1、MIP、MEP、下段食管括约肌(LES)静息压均高于治疗前(P<0.05),且治疗后观察组FVC、FEV1、MIP、MEP、LES静息压均高于对照组(P<0.05)。治疗后两组吞咽功能均优于治疗前(P<0.05),且治疗后观察组吞咽功能优于对照组(P<0.05)。治疗后两组LES长度均长于治疗前(P<0.05),且治疗后观察组LES长度长于对照组(P<0.05)。观察组随访期间COPD急性加重发作率18.18%(8/44)低于对照组40.91%(18/44)(P<0.05)。结论ADBT配合莫沙必利及奥美拉唑治疗GERD合并COPD,能缓解GERD症状,改善肺功能、吞咽功能、括约肌功能,减少随访期间COPD急性加重发作次数,提高病人生活质量。Objective To investigate the effects of abdominal deep breathing training(ADBT)combined with mosapride and omeprazole on the lung function and swallowing function of patients with gastroesophageal reflux disease(GERD)complicated with chronic obstructive pulmonary disease(COPD).Methods Eighty-eight patients with GERD complicated with COPD admitted to Bazhong Central Hospital from July 2019 to June 2020 were selected and assigned into control group(n=44,given mosapride and omeprazole)and study group(n=44,combined with ADBT on the basis of the control group)according to the random number table method.The two groups were compared in the reflux disease questionnaire(RDQ)scores,St.George's Respiratory Questionnaire(SGRQ)scores,lung function[vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximum inspiratory pressure(MIP),maximum Expiratory pressure(MEP)],swallowing function,sphincter function,and the incidence of acute exacerbations of COPD during the 1-year follow-up.Results After treatment,the RDQ score,SGRQ score,and upper esophageal sphincter(UES)resting pressure of the two groups were lower than before treatment(P<0.05),and the RDQ score[(13.39±4.01)vs.(19.28±4.93)],SGRQ score[(118.08±18.22)vs.(137.59±15.77)],and UES resting pressure[(40.72±4.49)mmHg vs.(52.96±5.49)mmHg]of the study group after treatment were all lower than those of the control group(P<0.05).After treatment,the FVC,FEV1,MIP,MEP,and lower esophageal sphincter(LES)resting pressure in the two groups were all higher than before treatment(P<0.05),and the FVC,FEV1,MIP,MEP,LES resting pressure in the study group were all higher than that in the control group(P<0.05).After treatment,the swallowing function of the two groups was better than before treatment(P<0.05),and the swallowing function of the study group was better than that of the control group after treatment(P<0.05).After treatment,the length of LES in the two groups was longer than before treatment(P<0.05),and the length of LES in the study group was longer than that

关 键 词：胃食管反流 肺疾病 慢性阻塞性 腹式深呼吸训练 莫沙必利 奥美拉唑 肺功能 吞咽功能 

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