Launois C, Mulette P, Ancel J, Dury S, Hagenburg J, Lebargy F, Dormoy V, Deslee G, Perotin J-M
Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; EA 4683, université de Reims Champagne-Ardenne, 51092 Reims, France.
Rev Mal Respir. 2021 Sep;38(7):733-742. doi: 10.1016/j.rmr.2021.04.013. Epub 2021 May 18.
Gastro-oesophageal reflux disease (GORD) is one of the most frequent conditions associated with asthma. GORD has an impact on asthma control and quality of life of asthmatic patients. Its treatment relies on lifestyle modifications, anti-acidic treatment with proton pump inhibitors (PPI) and/or surgical management by fundoplication in some situations. The impact of lifestyle modifications has not been analysed on asthma outcomes alone. Several randomised controlled trials assessed the efficacy of PPI on asthma control, peak expiratory flow and/or quality of life. The impact of fundoplication in asthma has mainly been analysed in retrospective or prospective observational studies. This review highlights the limited impact of GORD treatment on asthma control. Current guidelines are to restrict GORD treatment in asthma to asthmatic patients with actual symptomatic GORD. Given the lack of controlled studies, the place of surgical management of GORD in asthma is currently not defined.
胃食管反流病(GORD)是与哮喘相关的最常见病症之一。GORD会影响哮喘控制及哮喘患者的生活质量。其治疗依赖于生活方式的改变、使用质子泵抑制剂(PPI)进行抗酸治疗,以及在某些情况下通过胃底折叠术进行手术治疗。目前尚未单独分析生活方式改变对哮喘结局的影响。多项随机对照试验评估了PPI对哮喘控制、呼气峰值流速和/或生活质量的疗效。胃底折叠术对哮喘的影响主要在回顾性或前瞻性观察性研究中进行了分析。本综述强调了GORD治疗对哮喘控制的影响有限。当前指南建议将哮喘患者中GORD的治疗限制于有实际症状的GORD患者。鉴于缺乏对照研究,目前GORD手术治疗在哮喘中的地位尚未明确。