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八周服用20毫克奥美拉唑可显著减轻喉咽反流及共病的慢性鼻-鼻窦炎的体征和症状:随机、双盲、安慰剂对照试验。

Eight weeks of omeprazole 20 mg significantly reduces both laryngopharyngeal reflux and comorbid chronic rhinosinusitis signs and symptoms: Randomised, double-blind, placebo-controlled trial.

作者信息

Anzić S A, Turkalj M, Župan A, Labor M, Plavec D, Baudoin T

机构信息

ENT Department, Children's Hospital Srebrnjak, Zagreb, Croatia.

Department for Allergy and Pulmonology, Children's Hospital Srebrnjak, Zagreb, Croatia.

出版信息

Clin Otolaryngol. 2018 Apr;43(2):496-501. doi: 10.1111/coa.13005. Epub 2017 Oct 23.

DOI:10.1111/coa.13005
PMID:29024410
Abstract

OBJECTIVES

Gastroesophageal reflux recommended treatment (dose and duration) with proton-pump inhibitor (PPI) compared to placebo significantly reduces the signs and symptoms of laryngopharyngeal reflux (LPR) and comorbid chronic rhinosinusitis (CRS).

DESIGN

Double-blind randomised placebo-controlled trial.

SETTING

Eight weeks of treatment with omeprazole 20 mg once daily (OD).

PARTICIPANTS

Sixty patients (28 women, aged 19-87 years) with diagnosed LPR and comorbid CRS.

MAIN OUTCOME MEASURES

Significant reduction in signs and symptoms (reflux symptom index (RSI) score as subjective, and reflux finding score (RFS) as objective measure) of LPR after 8 weeks of treatment with omeprazole 20 mg OD when compared to placebo. Secondary objectives were significant reduction in signs and symptoms of comorbid CRS after 8 weeks of treatment with omeprazole 20 mg OD when compared to placebo and the association of the severity of signs and symptoms of LPR with the ones of CRS.

RESULTS

RSI and RFS decreased significantly more in the active treatment group after 8 weeks compared to placebo (P < .001 for both). CRS and endoscopy scoring decreased both significantly more in the active group after 8 weeks compared to placebo (P < .001 for both). CRS scoring significantly correlated with RSI (R = 0.312, P = .015) but not with RFS (R = 0.199, P = .127).

CONCLUSIONS

The results of our trial suggest that omeprazole 20 mg OD for 8 weeks was effective in reducing signs and symptoms of both LPR and CRS, although in most patients still present at the end of the trial.

摘要

目的

与安慰剂相比,质子泵抑制剂(PPI)治疗胃食管反流的推荐治疗方案(剂量和疗程)能显著减轻喉咽反流(LPR)和合并的慢性鼻-鼻窦炎(CRS)的体征和症状。

设计

双盲随机安慰剂对照试验。

设置

每日一次服用20mg奥美拉唑,为期8周的治疗。

参与者

60例确诊为LPR且合并CRS的患者(28名女性,年龄19 - 87岁)。

主要观察指标

与安慰剂相比,每日一次服用20mg奥美拉唑治疗8周后,LPR的体征和症状(主观的反流症状指数(RSI)评分和客观的反流发现评分(RFS))显著降低。次要目标是与安慰剂相比,每日一次服用20mg奥美拉唑治疗8周后,合并CRS的体征和症状显著减轻,以及LPR体征和症状的严重程度与CRS的体征和症状严重程度之间的关联。

结果

与安慰剂相比,8周后活性治疗组的RSI和RFS显著下降更多(两者P均<0.001)。与安慰剂相比,8周后活性组的CRS和内镜评分均显著下降更多(两者P均<0.001)。CRS评分与RSI显著相关(R = 0.312,P = 0.015),但与RFS无关(R = 0.199,P = 0.127)。

结论

我们试验的结果表明,每日一次服用20mg奥美拉唑,持续8周,对减轻LPR和CRS的体征和症状有效,尽管在试验结束时大多数患者仍有症状。

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