咳嗽变异型哮喘与胃食管反流的关系

　　【关键词】  咳嗽；哮喘；胃食管反流

　　Study on relationship between cough asthma and gastroesophageal reflux

　　LIU Tai,MA Rong-wei,YAO Yuan,et al.

　　Department of Internal Medicine,Hebei Provincial Corps Hospital,Chinese People’s Armed Police Forces,Shijiazhuang 050081,China

　　【Abstract】  Objective  Many studies reported that asthma was related to the gastroesophageal reflux,to study the relationship between cough asthma and gastroesophageal reflux,guide the treating methods of cough asthma.Methods  In the 200 cases of cough asthma,108 cases having gastroesophageal reflux were divided into two groups:the control group and the experimental group.Results  To compare the two groups, the remission rate of the experimental group more than the control group,there was statistically remarkable difference (P<0.05).Conclusion  There are about 54% cough asthma having gastroesophageal reflux. To reduce acid and improve the squirm of gastric can shorten the remission time.

　　【Key words】  cough；asthma；gastroesophageal reflux

　　随着医学的发展，对支气管哮喘的认识有了质的飞跃，相应的防治策略有了长足进步。哮喘全球创议的制定以及我国哮喘防治指南的制定和不断修改［1～3］充分说明了这点。咳嗽变异型哮喘是哮喘的特殊类型，没有哮鸣音。许多研究发现支气管哮喘与胃食管反流有关。应用各种方法治疗胃食管反流后，一些哮喘患者的病情得到明显缓解。本文研究咳嗽变异型哮喘与胃食管反流的关系，以指导其治疗，并缩短缓解时间，现总结报告如下。

　　1  资料与方法

　　1.1  一般资料  200例咳嗽变异型哮喘患者均来自我院门诊,将伴有胃食管反流的108例患者随机分为两组：对照组52例，实验组56例，两组年龄、性别、身高、体重均具有可比性。所有患者均经胃镜检查，伴有胃食管反流的患者，胃镜检查见食管下段黏膜呈条索状、充血、水肿，严重者可见糜烂。

　　1.2  方法  随机选取咳嗽患者，咳嗽时间>3周，口服止咳药效果欠佳,对其进行肺功能测定，连续测定3次，取其最高值;然后行支气管舒张试验：吸入硫酸沙丁胺醇气雾剂2喷，10min后测定肺功能，计算FEV1变异率。FEV1>15%者入选200例，对其行胃镜检查，伴食管下段黏膜改变者108例。将此108例随机分为两组，对照组吸入硫酸沙丁胺醇气雾剂和丙酸倍氯米松２喷,３次/d；实验组除吸入外，加服吗丁啉10mg,３次/d,法莫替丁20mg,2次/d。治疗效果见表1。

　　表1  两

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