泮托拉唑-莫沙必利联合治疗胃食管返流性咳嗽48例疗效研究.docVIP

泮托拉唑\莫沙必利联合治疗胃食管返流性咳嗽48例疗效研究【摘要】 目的 探讨胃食管返流性咳嗽(Gastro-esophageal Reflux Cough,GERC)的治疗方法。方法 回顾分析我院确诊的48例胃食管返流性咳嗽患者的临床表现、治疗方法及治疗效果。结果 48例患者给予抑酸、促胃动力药等治疗,2周后29例患者症状消失,4周后43症状消失,5例服药4周后症状明显缓解。结论 胃食管返流性咳嗽是慢性咳嗽常见的原因之一,通过改变饮食及睡眠习惯,应用抑酸剂及抗返流药物治疗胃食管返流性咳嗽疗效满意。 【关键词】胃食管返流;慢性咳嗽;治疗 Analysis of 48 cases involving cough caused by gastroesophageal reflux MI Cai-feng,LI Mei-jiao,HUANG Rui-na,et al.Department of gastroenterology,First People’s Hospital of Henan Province,Pingdingshan 467000,China 【Abstract】 Objective To investigate the treatment method of cough caused by gastroesophageal reflux.Methods The clinical data of 48 patients with cough caused by gastroesophageal reflux were retrospectively analyzed,who were diagnosed and treated in our hospital.Then the clinical futures treatment methods and curative effects were summed up.Results All the 48 patients were given Pantoprazole and Mosapride.The symptoms of 29 cases disappeared after 2 weeks,and 43 cases disappeared after 4 weeks,the symptoms of 5 cases improved obviously after 4 weeks.Conclusion GERC is a common cause of the chronic cough.By changing dietary and sleeping habit.taking anti-acid and anti-reflux medicine,it can get a good efficiency. 【Key words】Gastroesophageal reflux;Chronic cough;Treatment 胃食管返流性咳嗽(gastroesophageal reflux cough,GERC)是指因胃酸和其他胃内容物返流进入食管,导致以慢性咳嗽为主要临床表现,超过8周以上,胸部X线检查正常的慢性咳嗽。GERC是慢性咳嗽常见的原因之一,约占慢性咳嗽病因的10%~40%[1]。近年来的研究表明,胃食管返流与部分慢性咳嗽、反复发作性哮喘、阻塞型睡眠呼吸暂停综合征、心绞痛样胸痛有关[2],但一直未能引起临床医师的普遍重视,以致延误诊断和治疗。为提高对该病的认识,我院2007年2月至2009年7月联用泮托拉唑和莫沙必利加治疗胃食管返流性咳嗽48例,疗效满意,总结如下。 1 临床资料 1.1 一般资料 本组48例中,男37例,女11例,年龄23~70岁,平均年龄41岁,病程2月~5年,平均13个月。 1.2 临床表现 反复发作性咳嗽为首发或主要症状,27例伴有典型胃食管返流(反酸、暖气、烧心等)症状,15例无明显返流征,仅在进食时或进餐后发生咳嗽。6例患者咳嗽是唯一表现。 1.3 辅助检查 48例胸部正位片均未见异常,6例以咳嗽为唯一症状者作肺通气功能正常,支气管激发试验阴性,排除了咳嗽变异性哮喘、慢性支气管炎等。27例伴有返流症状者行电子胃镜检查,食管黏膜均有不同程度的点状、条状或片状的发红、糜烂,1例有食管溃疡,15例无返流症状者有,8例行电子胃镜见食管黏膜散在点状糜烂,48例中C14呼气实验检测HP阳性者16例。 2 治疗方法 莫沙必利片(瑞琪)5 mg,三餐前30 min服用,泮托拉唑肠溶胶囊(泮立苏)40 mg,早晚餐前30 min服用,疗程8~12周,合并胃炎者同时服用胃黏膜保