山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (3): 119-123.doi: 10.6040/j.issn.1673-3770.0.2018.472

• 论著 • 上一篇    下一篇

咽喉反流性疾病的影响因素及治疗效果分析

郎永耀1,杨云1,刘晴1,徐林弟1,林子萍1,2()   

  1. 1. 南京医科大学附属江苏盛泽医院 江苏省人民医院盛泽分院耳鼻咽喉科,江苏 苏州215228
    2. 南京医科大学第一附属医院 江苏省人民医院耳鼻咽喉科,江苏 南京210029
  • 收稿日期:2018-10-23 修回日期:2019-03-31 出版日期:2019-05-20 发布日期:2019-08-07
  • 通讯作者: 林子萍 E-mail:entl@sohu.com

Analysis of influencing factors and observation of therapeutic effects in patients with laryngopharyngeal reflux disease

Yongyao LANG1,Yun YANG1,Qing LIU1,Lindi XU1,Ziping LIN1,2()   

  1. 1. Department of Otorhinolaryngology, The Affiliated Jiangsu Shengze Hospital, Nanjing Medical University, Suzhou 215228, Jiangsu, China
    2. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2018-10-23 Revised:2019-03-31 Online:2019-05-20 Published:2019-08-07
  • Contact: Ziping LIN E-mail:entl@sohu.com

摘要: 目的

了解咽喉反流性疾病(LPRD)的影响因素和治疗效果。

方法

选取2018年2~8月门诊收治的112例咽喉疾病患者,通过反流症状指数评分量表(RSI)和反流体征评分量表(RFI)诊断。采用视觉模拟评分法(VSA)评分。采用饮食和生活习惯调整(一级治疗),质子泵抑制剂(PPI)和胃肠动力药治疗(二级治疗)4~6周。对年龄、性别、职业、饮食、受凉、压力、情绪、胃疾病史等进行单因素分析和二元Logistic回归分析,比较治疗前后的RSI和VSA评分。

结果

112例慢性咽喉疾病患者随访率90%,LPRD 83例,占门诊慢性咽喉疾病患者的83%。单因素分析结果显示,饮食(χ2=4.123, P<0.05)、胃疾病史(χ2=14.912, P<0.01)差异有统计学意义;而性别(χ2=0.681, P>0.05)、年龄(χ2=0.681, P>0.05)、职业(χ2=0.024,P>0.05)、受凉(χ2=0.649,P>0.05)、压力(χ2=1.197, P>0.05)、情绪(χ2=0.940,P>0.05)差异无统计学意义。二元Logistic回归分析结果显示,饮食(χ2=4.480,P<0.05)、胃疾病史(χ2=7.792, P<0.01)是LPRD的影响因素。临床治疗显效50.61%(41例)、有效37.01%(30例)、无效12.34%(10例)。轻症一级治疗前后VAS(t=9.41, P<0.01)和RSI(t=10.59, P<0.01),轻症一二级联合治疗VAS(t=20.59, P<0.01)和RSI(t=22.03, P<0.01), 重症一二级联合治疗VAS(t=6.82,P<0.05)和RSI(t=4.8, P<0.05)评分差异均有统计学意义。

结论

饮食、胃疾病史是LPRD的影响因素,调整饮食和生活习惯联合PPI和胃肠动力剂治疗LPRD效果较好。

关键词: 咽喉反流性疾病, 危险因素, 饮食, 胃疾病, 治疗结局

Abstract: Objective

To understand the influencing factor and therapeutic effects of laryngopharyngeal reflux disease(LPRD).

Methods

A total of 112 patients with chronic laryngopharyngeal disease were enrolled in this study in the period from February 2018 to August 2018. The patients were diagnosed with LPRD using the reflux symptom index(RSI), the reflux finding score (RFS), and the visual analogue scale(VAS) score. The patients with LPRD were treaded with modifications in diet and living habits(primary treatment) and. with proton pump inhibitors (PPIs) and prokinetic agents(secondary treatment) for 4-6weeks. Simultaneously, the factors of age, sex, occupation, diet, cold, stress, mood and gastric history were analyzed by single-factor and binary logistic regression analysis. In addition, RSI and VAS score before and after treatment was analyzed.

Results

Among the 112 patients with chronic laryngopharyngeal disease, the follow-up rate was 90%. Among patients with LPRD, chronic laryngopharyngeal disease was diagnosed in 83% (83 cases).Single-factor analysis showed that diet(χ2=4.124, P<0.05)and history of stomach problems (χ2=14.912, P<0.01)were statistically significant, whereas sex(χ2=0.681, P>0.05), age(χ2=0.681, P>0.05), occupation(χ2=0.024, P>0.05), cold(χ2=0.649, P>0.05), stress(χ2=1.197, P>0.05), and mood(χ2=0.940, P>0.05) were not statistically significant. Binary logistic regression analysis showed that diet(x2=4.480, P<0.05) and history of stomach(χ2=7.792, P<0.01) were the influencing factors of LPRD. The clinical efficacy of treatment was significant in 50.61% (41 cases), effective in 37.07%(30 cases) and ineffective in 12.34%(10 cases). The differences of VAS(t=9.41, P<0.01) and RSI(t=10.59, P<0.01)score were statistically significant before and after primary treatment for mild LPRD. The differences of VAS(t=20.59, P<0.01) and RSI(t=22.03,P<0.01)score were statistically significant before and after primary combined with secondary treatment for mild LPRD. The differences of VAS(t=6.82,P<0.05) and RSI(t=4.8, P<0.05) score were statistically significant before and after primary combined with secondary treatment for severe LPRD.

Conclusion

LPRD was a common disease in the otorhinolaryngology clinic. Diet and history of stomach problems were the influencing factors of LPRD. It was treated effectively by adjusting diet and living habits combined with PPI and prokinetic agents.

Key words: Laryngopharyngeal reflux disease, Risk factors, Diet, Stomach diseases, Treatment outcome

中图分类号: 

  • R767

表1

81例LPRD患者治疗前后疗效评估比较( xˉ±s,分)"

组别一级治疗(轻症)一二级治疗(轻症)一二级治疗(重症)
VAS评分RIS评分VAS评分RIS评分VAS评分RIS评分
治疗前4.77±0.9714.68±1.288.39±0.6314.45±2.058.00±1.0017.22±4.26
治疗后1.69±1.615.50±3.772.94±1.803.62±3.075.11±1.907.55±3.46
t9.4110.5920.5922.036.824.8
P<0.01<0.01<0.01<0.01<0.05<0.05

表2

咽喉疾病100例单因素分析"

因素例数

LPRD

[n(%)]

χ2P
性别0.6810.411
6352(62.7)
3731(37.3)
年龄(岁)0.6810.441
≤454740(48.2)
>455343(51.8)
职业0.0240.877
脑力1312(14.4)
体力3931(37.3)
自由职业4840(48.2)
饮食4.1230.045
嗜酒、暴饮暴食4844(53.0)
5239(47.0)
受凉0.6490.422
2724(28.9)
7359(71.1)
压力1.1970.277
2116(19.3)
7967(80.7)
焦虑忧郁状态0.9400.335
1413(15.7)
8670(84.3)
胃疾病史14.9120.000
5452(62.7)
4631(37.3)

表3

咽喉反流性疾病二元Logistic回归分析"

指标βSEWals χ2P OR(95%CI
饮食1.5100.7134.4800.034 4.526(1.421~41.807)
胃疾病史2.3190.8317.7920.005 10.165(2.595~87.617)
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