抑酸剂不能改善同患哮喘和胃食管反流儿童的呼吸道症状

来源 :世界核心医学期刊文摘(儿科学分册) | 被引量 : 0次 | 上传用户:semitic
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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. 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 randomized to 12 weeks of 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 e 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 (95% CI -0.72 to 3.27 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 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.
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