山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (1): 67-69.doi: 10.6040/j.issn.1673-3770.0.2015.433

• 论著 • 上一篇    下一篇

喉咽反流性疾病的临床治疗研究

陈寻1,杨云2,陈智斌1   

  1. 1. 南京医科大学, 江苏 南京 210029;
    2. 江苏盛泽医院耳鼻咽喉头颈外科, 江苏 苏州 215228
  • 收稿日期:2015-10-19 出版日期:2016-02-16 发布日期:2016-02-16
  • 通讯作者: 陈智斌. E-mail:czbnj@163.com E-mail:chenxun911@163.co
  • 作者简介:陈寻. E-mail:chenxun911@163.co

Research on diagnosis and treatment of laryngopharyngeal reflux disease.

CHEN Xun1, YANG Yun2, CHEN Zhibin1   

  1. 1. Nanjing Medical University, Nanjing 210029, Jiangsu, China;2. Department of Otolaryngology &Head Neck Surgery, Jiangsu Shengze Hospital, Suzhou 215228, Jiangsu, China
  • Received:2015-10-19 Online:2016-02-16 Published:2016-02-16

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摘要： 目的 探讨喉咽反流性疾病(LPRD)的诊疗方法,同时观察LPRD患者幽门螺杆菌检出率。 方法 156例反流症状指数(RSI)>13分和/或反流体征指数(RFS)>7分临床确诊为LPRD的患者,进行13C-尿素呼气试验(13C-UBT)［4］检测,检出Hp阳性患者(I组)进行2周的幽门螺杆菌四联疗法［5］(奥美拉唑+枸橼酸铋钾+阿莫西林+克林霉素)+甘桔冰梅片治疗后停药4周,观察Hp转阴率及LPRD转阴率;将Hp阴性患者随机分为2组,II组30例单纯给予甘桔冰梅片治疗4周后观察LPRD转阴率,III组30例给予奥美拉唑+莫沙必利+甘桔冰梅片治疗4周后观察LPRD转阴率。 结果 Hp阳性检出率为61.54%(96/156),经治疗2周后停药,4周复查Hp转阴率为78.12%(75/96),I组治疗后LPRD转阴率为67.71%(65/96),II组转阴率为53.33%(16/30),III组转阴率为96.67%(29/30)。经治疗后,三组RSI和RFS评分均较治疗前降低,差异有统计学意义(t=6.73,P<0.001)。治疗后III组与II组比较,III组的RSI和RFS评分更低。 结论 喉咽反流是导致咽喉炎的重要病因,使用抑酸剂及消化道促动力剂可明显改善喉咽反流的症状及体征。

关键词: 幽门螺杆菌, 喉咽反流性疾病, 13碳尿素呼气试验, 幽门螺杆菌四联疗法

Abstract: Objective To discuss the diagnosis and treatment method of laryngopharyngeal reflux disease(LPRD), and to observe the detection rate of helicobacter pylori from the patients with LPRD. Methods A Total of 156 LPRD patients with reflux symptom index(RSI)over 13 and/or reflux symptom index(RFS)>7 were supplied with 13C-Urea Breath Test(13C-UBT). The Hp positive patients(n=96, group I)were administrated with quadruple therapy(Omeprazole+Bismuth Potassium Citrate+Amoxicillin+Clindamycin)and Ganju Bingmei tablets for 2 weeks, followed up with a 4 weeks of withdrawal period. The primary ourcome observed was of Hp negative transformation rate and curative effect evaluation before and after the treatment; Hp negative patients were divided into group II and group III, with 30 cases in each group. The group II was given Ganju Bingmei tablets for 4 weeks and the group III was administrated with Omeprazole+Bismuth Potassium Citrate and Ganju Bingmei Tablets for 4 weeks. The main outcome was LPRD and HP negative-converting rate. Results The Hp negative-converting rate was 78.12%(75/96)in group I. The LPRD negative-converting rate in group I, group II and group III was 67.71%(65/96), 53.33%(16/30)and 96.67%(29/30), respectively.The score of RSI and RFS were decreased in all three groups after treatment, and dropped more significantly in group III(Statistic:6.73,P<0.001). Conclusion Laryngopharyngeal reflux, as an important cause of sphagitis, can be improved by using antiacid and gastrointestinal prokinetic agents.

Key words: Helicobacter pylori, Helicobacter pylori quadruple therapy, Laryngopharyngeal reflux disease, 13C-Urea Breath Test

中图分类号: 

  • R766
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