目的探讨质子泵抑制剂对胃食管反流性咽喉炎的治疗作用及其安全性,为胃食管反流性咽喉炎的临床治疗提供指导依据。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge databases、VIP、CNKI、CBM和WANFANG数据库,查找所...目的探讨质子泵抑制剂对胃食管反流性咽喉炎的治疗作用及其安全性,为胃食管反流性咽喉炎的临床治疗提供指导依据。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge databases、VIP、CNKI、CBM和WANFANG数据库,查找所有探讨质子泵抑制剂对胃食管反流性咽喉炎治疗作用的随机对照试验,检索时限均为建库至2012年3月2日。同时手检纳入文献的参考文献。按纳入排除标准由3名研究者独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价。结果共纳入8个研究,591例患者。Meta分析结果显示:质子泵抑制剂治疗胃食管反流性咽喉炎的总体有效率[OR=7.79,95%CI(2.20,27.51),P<0.05]高于对照组,咳嗽症状缓解效率[OR=2.29,95%CI(0.83,6.35),P>0.05],与对照组比较差异不显著,内镜检查好转率[OR=18.83,95%CI(1.86,190.60),P<0.05],高于对照组。结论质子泵抑制剂对胃食管反流性咽喉炎的治疗作用较对照组明显;但因纳入研究较少、质量参差不齐、样本含量小、各研究方法变异性大,建议临床上审慎选择使用;需要更多高质量、大样本、多中心的随机对照试验进一步论证。展开更多
Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or ex...Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or exacerbating existing pulmonary disease,such as asthma or chronic obstructive pulmonary disease.In addition to the respiratory manifestation of GERD,there are unique pharyngeal and laryngeal manifestations.These include voice hoarseness,throat-clearing,chronic cough,globus,and "post-nasal drip".Linking these symptoms to GERD is challenging and frequently the diagnosis is that of exclusion.Despite proton pump inhibitor therapy being the mainstay of treatment,with anti-reflux surgery being reserved for intractable cases,there is no definitive evidence of the superiority of either.展开更多
文摘目的探讨质子泵抑制剂对胃食管反流性咽喉炎的治疗作用及其安全性,为胃食管反流性咽喉炎的临床治疗提供指导依据。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge databases、VIP、CNKI、CBM和WANFANG数据库,查找所有探讨质子泵抑制剂对胃食管反流性咽喉炎治疗作用的随机对照试验,检索时限均为建库至2012年3月2日。同时手检纳入文献的参考文献。按纳入排除标准由3名研究者独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价。结果共纳入8个研究,591例患者。Meta分析结果显示:质子泵抑制剂治疗胃食管反流性咽喉炎的总体有效率[OR=7.79,95%CI(2.20,27.51),P<0.05]高于对照组,咳嗽症状缓解效率[OR=2.29,95%CI(0.83,6.35),P>0.05],与对照组比较差异不显著,内镜检查好转率[OR=18.83,95%CI(1.86,190.60),P<0.05],高于对照组。结论质子泵抑制剂对胃食管反流性咽喉炎的治疗作用较对照组明显;但因纳入研究较少、质量参差不齐、样本含量小、各研究方法变异性大,建议临床上审慎选择使用;需要更多高质量、大样本、多中心的随机对照试验进一步论证。
文摘Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or exacerbating existing pulmonary disease,such as asthma or chronic obstructive pulmonary disease.In addition to the respiratory manifestation of GERD,there are unique pharyngeal and laryngeal manifestations.These include voice hoarseness,throat-clearing,chronic cough,globus,and "post-nasal drip".Linking these symptoms to GERD is challenging and frequently the diagnosis is that of exclusion.Despite proton pump inhibitor therapy being the mainstay of treatment,with anti-reflux surgery being reserved for intractable cases,there is no definitive evidence of the superiority of either.