Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (3): 119-123.doi: 10.6040/j.issn.1673-3770.0.2018.472

• Original Article • Previous Articles     Next Articles

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

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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

CLC Number: 

  • R767

Table 1

Clinical evaluation of 81 patient with LPRD before and after treatment ( xˉ±s,scores)"

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

Table 2

Single factor analysis of 100 cases of laryngopharyngeal disease"

因素例数

LPRD

[n(%)]

χ2P
性别0.6810.411
男6352（62.7）
女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)
无5239(47.0)
受凉0.6490.422
有2724(28.9)
无7359(71.1)
压力1.1970.277
有2116(19.3)
无7967(80.7)
焦虑忧郁状态0.9400.335
有1413(15.7)
无8670(84.3)
胃疾病史14.9120.000
有5452(62.7)
无4631(37.3)

Table 3

Binary logistic regression analysis of LPRD"

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）
1 韩德民, T. SataloffRobert , 徐文. 嗓音医学[M]. 2版. 北京: 人民卫生出版社, 2017:194-200.
2 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）[J]. 中华耳鼻咽喉头颈外科杂志，2016, 51（5）：324-326.doi：10.3760/cma.j.issn.1673-0860.2016.05.002.
doi: 10.3760/cma.j.issn.1673-0860.2016.05.002
LIJinrang,XIAOShuifang,LIXiangping， et al. Experts consensus on diagnosis and treatment of Laryngopharyngeal ruflux disease (2015)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2016, 51 (5):324-326.doi：10.3760/cma.j.issn.1673-0860.2016.05.002.
doi: 10.3760/cma.j.issn.1673-0860.2016.05.002
3 BacciuA, MercanteG, IngegnoliA, et al. Effects of gastroesophageal reflux disease in laryngeal carcinoma[J]. Clin Otolaryngol Allied Sci, 2004, 29(5): 545-548. doi:10.1111/j.1365-2273.2004.00851.x.
doi: 10.1111/j.1365-2273.2004.00851.x
4 CohenJT, BachKK, PostmaGN, et al. Clinical manifestations of laryngopharyngeal reflux[J]. Ear Nose Throat J, 2002, 81(9 Suppl2): 19-23.PMID: 12353427.
5 李湘平, 黄柞峰, 吴婷, 等. 咽喉反流在声带白斑及早期声带癌发病中的初步观察[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(5): 362-367. doi:10.3760/cma.j.issn.1673-0860.2014.05.003.
doi: 10.3760/cma.j.issn.1673-0860.2014.05.003
LIXiangping, HUANGZuofeng, WUTing, et al. Role of laryngopharyngeal reflux on the pathogenesis of vocal cord leukoplakia and early glottic cancer[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2014, 49(5): 362-367. doi:10.3760/cma.j.issn.1673-0860.2014.05.003.
doi: 10.3760/cma.j.issn.1673-0860.2014.05.003
6 邓月琴, 王路, 陈怀宏, 等. 胃蛋白酶在舌扁桃体组织中的表达及临床意义[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(7): 525-530. doi:10.3760/cma.j.issn.1673-0860.2017.07.009.
doi: 10.3760/cma.j.issn.1673-0860.2017.07.009
DENGYueqin, WANGLu, CHENHuaihong, et al. Expression and significance of pepsin in lingual tonsil hypertrophy[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(7): 525-530. doi:10.3760/cma.j.issn.1673-0860.2017.07.009.
doi: 10.3760/cma.j.issn.1673-0860.2017.07.009
7 李进让.咽喉反流性疾病的规范化诊断与治疗[J]. 中国耳鼻咽喉头颈外科, 2015, 22（9）：435-437. doi:10.16066/j.1672-7002.2015.09.001.
doi: 10.16066/j.1672-7002.2015.09.001
LIJinrang. The benchmarking diagnosis and therapy of laryngopharyngeal reflux disease[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2015, 22(9): 435-437. doi:10.16066/j.1672-7002.2015.09.001.
doi: 10.16066/j.1672-7002.2015.09.001
8 李可亮, 李进让. 质子泵抑制剂联合胃肠动力药治疗咽喉反流性疾病的Meta分析[J]. 中国耳鼻咽喉头颈外科, 2014, 21(7): 367-371.
LIKeliang, LIJinrang. Meta analysis of proton pump inhibitor and proton pump inhibitor with prokinetic agents in the treatment of laryngopharyngeal reflux disease[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2014, 21(7): 367-371.
9 陈寻，杨云，陈智斌.喉咽反流性疾病的临床治疗研究[J]. 山东大学耳鼻咽喉眼学报，2016 , 30（1）: 67-69, 73. doi:10.6040/j.issn.1673-3770.0.2015.433.
doi: 10.6040/j.issn.1673-3770.0.2015.433
CHENXun,YANGYun,CHENZhibin. Clinical treaterment of laryngeal and pharyngeal reflux disease[J]. Journal of Otorhinolaryngology and Ophthalmology of Shandong University, 2016，30（1）67-69, 73. doi:10.6040/j.issn.1673-3770.0.2015.433.
doi: 10.6040/j.issn.1673-3770.0.2015.433
10 孙娜，陈晓平.咽喉反流性疾病与咽喉科疾病[J]. 山东大学耳鼻咽喉眼学报，2016，30（6）: 85-89. doi:10.6040/j.issn.1673-3770.0.2016.213.
doi: 10.6040/j.issn.1673-3770.0.2016.213
SUNNa, CHENXiaoping. Laryngopharyngeal diseases[J]. Journal of Otorhinolaryngology and Ophthalmology of Shandong University,2016，30（6）85-89. doi:10.6040/j.issn.1673-3770.0.2016.213.
doi: 10.6040/j.issn.1673-3770.0.2016.213
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