咽喉反流性疾病的影响因素及治疗效果分析

doi:10.6040/j.issn.1673-3770.0.2018.472

摘要/Abstract

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

郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.

Yongyao LANG,Yun YANG,Qing LIU,Lindi XU,Ziping LIN. Analysis of influencing factors and observation of therapeutic effects in patients with laryngopharyngeal reflux disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 119-123.

图/表 3

表1

表2

咽喉疾病100例单因素分析"

因素	例数	LPRD [n(%)]	$χ 2$	P
性别			0.681	0.411
男	63	52（62.7）
女	37	31（37.3）
年龄(岁)			0.681	0.441
≤45	47	40（48.2）
>45	53	43（51.8）
职业			0.024	0.877
脑力	13	12(14.4)
体力	39	31(37.3)
自由职业	48	40(48.2)
饮食			4.123	0.045
嗜酒、暴饮暴食	48	44(53.0)
无	52	39(47.0)
受凉			0.649	0.422
有	27	24(28.9)
无	73	59(71.1)
压力			1.197	0.277
有	21	16(19.3)
无	79	67(80.7)
焦虑忧郁状态			0.940	0.335
有	14	13(15.7)
无	86	70(84.3)
胃疾病史			14.912	0.000
有	54	52(62.7)
无	46	31(37.3)

表2

表3

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组别	一级治疗（轻症）		一二级治疗（轻症）		一二级治疗（重症）
组别	VAS评分	RIS评分	VAS评分	RIS评分	VAS评分	RIS评分
治疗前	4.77±0.97	14.68±1.28	8.39±0.63	14.45±2.05	8.00±1.00	17.22±4.26
治疗后	1.69±1.61	5.50±3.77	2.94±1.80	3.62±3.07	5.11±1.90	7.55±3.46
t	9.41	10.59	20.59	22.03	6.82	4.8
P	<0.01	<0.01	<0.01	<0.01	<0.05	<0.05

指标	β	SE	Wals χ²	P OR	（95%CI）
饮食	1.510	0.713	4.480	0.034 4.526	（1.421~41.807）
胃疾病史	2.319	0.831	7.792	0.005 10.165	（2.595~87.617）