Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (2): 86-89.doi: 10.6040/j.issn.1673-3770.0.2018.252

Previous Articles    

Treatment of coexisting obstructive sleep apnea and laryngopharyngeal reflux disease and analysis of its characteristic reflux symptom index and reflux finding score

HU An, XING Yanli, CHEN Xiaoping, XUE Xiaocheng, ZHANG Yi, XU Weihua   

  1. Department of Otorhinolaryngology, Public Hospital of Shanghai Pudong District, Shanghai 200135, China
  • Published:2019-03-28

PDF (PC)

265

Abstract: Objective To analyze the reflux finding score(RFS)and reflux symptom index(RSI)in patients with laryngopharyngeal reflux disease(LPRD)and obstructive sleep apnea syndrome(OSAS)and to observe the clinical treatment effect. Methods Between January 2016 and December 2017, 100 patients with LPRD were selected. Patients with OSAS were included as the observation group(n=39), and the rest were observed as the control group(n=61). The RFS and RSI were assessed in the two groups. The RSI, RFS, apnea-hypopnea index(AHI), blood oxygen saturation(SaO2), total reflux, and total reflux time were compared after 2 months of treatment. Results The total RFS and RSI scores in the observation group were significantly higher than those in the control group. The difference in the signs of RFS was statistically significant(P<0.05). Subglottic edema, disappearance of the laryngeal chamber, anaphylactic erythema/congestion, laryngeal mucosal edema, and the posterior combined hypertrophy or swelling score were significantly higher in the observation group than in the control group(P<0.05). In the RSI, the dyspnea, heartburn, chest pain, acid reflux, and gastric acid reflux scores were significantly higher in the observation group than in the control group(P<0.05). After treatment, the RSI scores in the observation group were higher than those in the control group(P<0.05), but the control group had significantly better dyspnea, heartburn, chest pain, and acid reflux scores than did the observation group(P<0.05). Before and after treatment, the AHI, SaO2, and total reflux of the two groups were significantly different(P<0.05). The AHI and SaO2 of the observation group showed a significant improvement after treatment than before treatment(P<0.05). The total reflux and total reflux time showed significant improvements in both the groups, but the improvement was better in the control group than in the observation group(P<0.05). Conclusion Coexisting OSAS may aggravate the symptoms associated with laryngopharyngeal reflux in patients with LPRD, which may be the cause of poor treatment outcome and symptom improvement in patients with LPRD.

Key words: Laryngopharyngeal reflux, Obstructive sleep apnea syndrome, Reflux finding score, Reflux symptom index

CLC Number: 

  • R766
[1] 程鹏,张晓红,周跟东.高血压合并阻塞性睡眠呼吸暂停综合征患者的动脉硬化程度比较[J].安徽医学,2017(3):309-312. CHENG Peng, ZHANG Xiaohong, ZHOU Gendong. Comparative study of atherosclerosis and inflammatory response in patients of hypertension with different levels of obstructive sleep apnea hypopea syndrome[J]. Anhui Med J, 2017(3):309-312.
[2] 梁国良,周志森,杨智学, 等.阻塞性睡眠呼吸暂停低通气综合征与夜间咽喉反流的相关性研究[J].中国医学创新,2015(29):27-29. LIANG Guoliang, ZHOU Zhisen, YANG Zhixue, et al. Correlation between obstructive sleep apnea hypopnea syndrome and nocturnal pharyngeal reflux[J]. Med Innovationof Chin, 2015(29):27-29.
[3] Fridman M, Maley A, Kelley K, et al. Impact of pH monitoring on laryngopharyngeal reflux treatment improved compliance and symptom resolution[J]. Otolaryngol Head Neck Surg, 2011, 144(4):558-562.
[4] 柴小花,张宁,许艳芳,等.质子泵抑制剂在阻塞性睡眠呼吸暂停低通气综合征伴咽喉反流者中的应用[J].中国耳鼻咽喉颅底外科杂志,2012,18(3):179-182. CHAI Xiaohua, ZHANG Ning, XU Yanfang, et al. Application of proton pump inhibitor in obstructive sleep apnea hypopnea syndrome with reflux[J]. Chin J Otorhinolaryngol Skull Base Surger, 2012, 18(3): 179-182.
[5] Eryılmaz A, Erien L, Demir UL, et al. Man-Agement of patients with coexisting obstructive sleep Apnea and laryngopharyngeal reflux disease[J]. Eur Arch Otorhinolaryngol, 2012, 269(12):2575-2580.
[6] 张帆,彭一纯,冯宇莉.雷贝拉唑对咽喉反流伴阻塞性睡眠呼吸暂停低通气综合征患者的疗效分析[J].牡丹江医学院学报,2013,34(1):42-44. ZHANF Fan, PENG Yichun, FENG Yuli. Therapeutic effect of rabeprazole on patients with pharyngeal reflux with obstructive sleep apnea hypopnea syndrome[J]. J Mudanjiang Med Coll, 2013, 34(1):42-44.
[7] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉科学分会.儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J].中华耳鼻咽喉头颈外科杂志,2007,42(2):83-84. Editorial Board of Chinese Journal of Otorhinolary.Chinese Otorhinolaryngology of Chinese Medical Ass. Draft of guidelines for the diagnosis and treatment of pediatric sleep apnea hypopnea syndrome(Urumqi)[J]. Chin J Otorhinolaryngology Head and Neck Surg, 2007, 42(2):83-84.
[8] Thomas JP, Zubiaur M. Over-diagnosis of laryngopharyngeal reflus as the cause of hoarseness[J]. Eur Arch Otorhinolaryngol, 2013, 270(10):995-999.
[9] 刘庆松,闫燕.咽喉反流的客观诊断方法探讨[J].临床耳鼻咽喉头颈外科杂志,2014,28(19):1536-1540. LIU Qingsong, YAN Yan. Exploration of Objective Diagnosis of Throat Reflux[J]. Clin J Otorhinolarynol Head Neck Surg, 2014, 28(19):1536-1540.
[10] 李进让.咽喉反流性疾病规范化诊断和治疗[J]. 中华耳鼻咽喉科头颈外科杂志,2015,9(22):435-437. LI Jinrang. Standardized diagnosis and treatment of throat reflux disease[J]. Chin J Otorhinolarynol Head Neck Surg, 2015, 9(22):435-437.
[11] 李进让,Peter C Belafsky,张立红.中国喉科医师应用反流体征评分量表的信度研究[J].中华耳鼻咽喉头颈外科杂志,2012,19(3):388-390. LI Jinrang, Belafsky PC, ZHANG Lihong. Reliability study of Chinese otolaryngologists using the anti-fluid scoring scale[J]. Chin J Otorhinolarynol Head Neck Surg, 2012, 19(3):388-390.
[12] 郑杰元,张立红,李晶兢,等.咽喉反流症状指数量表中文版的信度及效度评价[J].中华耳鼻咽喉头颈外科杂志,2012,47(11):894-898. ZHENG Jieyuan, ZHANG Lihong, LI Jingqi, et al. Throat reflux symptoms refer to the reliability and validity of the Chinese version of the quantitative table[J]. Chin J Otorhinolarynol Head Neck Surg, 2012, 47(11):894-898.
[13] 李进让,肖水芳,李湘平,等.咽喉反流性疾病诊断与治疗专家共识(2015年)解读[J].中华耳鼻咽喉头颈外科杂志,2016,51(5):327-332 LI Jinrang, XIAO Shuifang, LI Xiangping, et al. Interpretation of the Experts on Diagnosis and Treatment of Throat Reflux Disease(2015)[J]. Chin J Otorhinolarynol Head Neck Surg, 2016, 51(5):327-332.
[1] TAO Yanli, YUAN Tiejun. Diagnostic value of detection of pepsin in the saliva for laryngopharyngeal reflux [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 52-55.
[2] LIU Dawei, ZHANG Yu, LI Chenglin, CHEN Xiumei, SONG Xicheng. Use of enhanced recovery after surgery in children with obstructive sleep apnea syndrome during the perioperative period [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 19-22.
[3] WANG Gang, WU Wei, WANG Lei, LIU Hongdan, XU Xiaohang, XU Bingxin, DING Ruiying, ZHOU Ying, HAN Haolun, GONG Jing,LI Baowei, SUN Zhezhe. Correlation analysis between Ryan index and reflux symptom index and reflux finding score, in the diagnosis of [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 48-52.
[4] LI Ping. The traditional Chinese understanding and treatment on laryngopharyngeal reflux. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 103-105.
[5] SUN Na, CHEN Xiaoping. Laryngopharyngeal reflux and otorhinolaryngology diseases [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 85-89.
[6] XUE Rong, ZHANG Xilong. Relationship between obstructive sleep apnea and pharyngeal muscles and structure. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 9-12.
[7] HE Guijun, QIAN Xiaoyun, GU Yajun, LIN Chuanyao, SONG Panpan, GAO Xia. Analysis of the risk factors of proliferative laryngopharyngeal disease. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 32-36.
[8] ZHOU Feng, WANG Xingjun, ZHAO Jun, ZHANG Shaobin. Clinical observation of anti-reflux treatment in patients with pharyngealforeign body sensation complicated with laryngopharyngeal reflux [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 29-31.
[9] CHEN Xun, YANG Yun, CHEN Zhibin. Research on diagnosis and treatment of laryngopharyngeal reflux disease. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 67-69.
[10] WU Hao,DING Xiao-jun,ZHOU Wei-rong,LU Jun,YOU Yi-wen,NIU Guan-yi,CHENG Ya-quan . Hard palate shortening combined with uvulopalatopharyngolasty in the treatment of obstructive sleep apnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(4): 297-299 .
[11] LUO Xin-an,SUN Zheng-liang . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(4): 343-344 .
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd