The Observation Of The Effect Of The Therapy Of The Nasal-continuous Positive Airway Pressure Combined With Anti-influx Drugs On The Elderly Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS) Patients With Gastro-esophageal Reflux Disease (GERD)

ObjectiveTo observe the therapeutic effect of nasal-continuous positive airway pressure (NCPAP) with anti-influx medicine on the elderly obstructive sleep apnea hypopnea syndrome (OSAHS) patients with gastro-esophageal reflux disease(GERD).MethodFrom July2011to May2012, we chose148OSAHS patients diagnosed by poly-somno-graphy (PSG), and before the diagnosing of PSG, these patients filled in Epworth Sleepiness Scale(ESS) in order to evaluate somnolence lever:among these,60patients were diagnosed gastro-esophageal reflux disease by gastro-esophageal reflux disease diagnosed questionnaire, among these patients,47patients participated in our test; at follow-up,5patients missed to contact; we divided the patients into4groups by randomized blocks design,10patients in controll group;8patients use anti-reflux drugs therapy:omeprazple20mg two times a day (before the diet) and itopride hydrochloride tablets50mg three times a day (before the diet);14patients were treated with the NCPAP;10patients were treated with the NCPAP and the anti-reflux medicine, the therapy of the drugs and the NCPAP as the same as the above two; the course of the therapy was30days。As soon as the course was over, we rechecked the ESS, PSG and GERDQ in order to reappraise the relevant factors about sleep respiration and gastro-esophagea。when the test ends, we applied matched t-test to evaluate each group’s therapy effect (pre-therapy vs post-therapy); We use the randomized block design analysis of variance and the student-newman-keuls test to evaluate the relevant factors about OSAHS and GERD among the four groups.Result:1In our test, GERD has a higher prevalence on the elderly OSAHS patients than normal elderly population, and is high as40.54%.2The patient basic statistic:on the height, weight, age, AHI and GERDQ, there is no statistical significance in four groups (P>0.05)3We use the paried/matched t-test to evaluate the effect of each group’s therapy(pre-therapy to post-therapy), and have such a result:①there is no statistical significance on GERQ score (10.2±3.5vs10.7±4.4), AHI (33.6±1.8vs37.5±1.1), ESS score (10.5±3.2vs11.9±3.0) On the control group;②there is a statistical significance on GERQ score (11.1±3.1vs7.5±2.3), AHI (36.1±1.3vs27.7±1.1), ESS score(10.1±3.2vs9.3±2.8), LSaO2(%)(75.8±1.4vs82.8±1.2)(P<0.05) on the CPAP group;③there is a statistical significance on GERQ score (10.3±4.0vs6.6±2.0) on the anti-reflux group (the pre-therapy to post-therapy)(P<0.05); there is no statistical significance on AHI index (36.4±1.3vs 35.4±1.1), ESS score (11.7±3.7vs8.8±3.7), LSaO2(%)(74.2±1.0vs76.3±1.2) on the anti-reflux group (the pre-therapy to post-therapy),(P>0.05);④there is a statistical significance on GERQ score (10.6±3.4vs5.6±2.1),AHI(35.6±1.2vs15.5±5.5), ESS score(11.2±2.7vs6.5±1.4), LSaO2(%)(74.5±1.5vs86.2±8.4) on the NCPAP combined with the anti-reflux medicine group;4We use the randomized block design analysis of variance and the student-newman-keuls test to evaluate the relevant factors about OSAHS and GERD among groups, and have a such result:①On the GERDQ score, there is a statistical significance between the three therapy groups and the control group (P<0.05);②On the lowest saturation of blood oxygen(%), the anti-reflux group have statistical significance among the nasal continuous positive airway pressure group, and the treatment with NCPAP combined with anti-reflux drugs group (P<0.05),there is no statistical significance between the CPAP group, and the NCPAP combined with anti-reflux drugs group (P>0.05); also there is no statistical significance between the anti-reflux drugs group and the control group (P>0.05)③On AHI, there is no statistical significance between the anti-reflux drugs group and the NCPAP group (P>0.05); and there is a statistical significance amony the anti-reflux group、the NCPAP group and the NCPAP combined with anti-reflux drugs group (P<0.05),and the NCPAP combined with anti-reflux drugs group has a better effective; there is no statistical significance between the anti-reflux drugs group and the control group (P>0.05)④On the ESS score, there is a statistical significance between the three therapy groups and the control group (P<0.05); also a statistical significance between the NCPAP group and the NCPAP combined with anti-reflux drugs group (P<0.05)ConclusionThere is a higher prevalence of GERD on the elderly OSAHS patients than normal elderly population。 To the elderly patient diagnosed OSAHS with GERD, the therapy of the treatment with NCPAP and anti-reflex drugs may be more effective。...