平逆方联合抗酸药治疗咽喉反流病伴有OSAHS的研究  

Therapeutic effect of the Pingni decoction combined with anti-acid therapy on treating liver stomach heat accumulation syndrome of laryngopharyngeal reflux disease accompanied with obstructive sleep apnea-hypopnea syndrome

作　　者：杨艳[1] 吴昆仑[2] 徐峰 陈珏 周中铭 胥伟华 YANG Yan;WU Kunlun;XU Feng;CHEN Jue;ZHOU Zhongming;XU Weihua(Shanghai Pudong New District Punan Hospital ENT Department,Shanghai,200125,China)

机构地区：[1]上海市浦东新区浦南医院耳鼻咽喉科,200125 [2]上海市浦东新区公利医院耳鼻咽喉科 [3]上海市普陀区中心医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2023年第4期275-280,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：上海市卫计委中西医结合专项基金(ZHYY-ZXYJHZX-201917)。

摘　　要：目的分析平逆方联合抗酸药治疗肝胃郁热型咽喉反流病(LPRD)伴有睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法抽取104例诊断为肝胃郁热型LPRD伴有OSAHS的患者,根据随机分组将患者分为“平逆方”+抗酸治疗组为A组(例=42)、“平逆方”组为B组(例=38)、抗酸组为C组(例=24),比较治疗2个月和6个月后反流症状指数量表(RSI)和反流体征指数量表(RFS)评分、酸与非酸的回流值。结果跟治疗前相比,除了方案三抗酸治疗组对非酸性回流值(pH>7)的降低效果不明显外,方案A、B、C治疗都观察到了明显的疗效(P<0.05)。同时,三个方案2个月与6个月疗效相比,治疗效果随着时间的延长而提高(P<0.05)。将三方案各指标按照治疗前后指标的降低分数做统计分析,可得:方案A与方案B相比,治疗后6个月,RSI、RFS、酸性回流值改善较优(P<0.05)。方案A与方案C相比,治疗后6个月,RSI、RFS、非酸性回流值改善较优(P<0.05)。结论平逆方联合抗酸药治疗比单一治疗可以更好改善LPRD症状。Objective To evaluate the therapeutic effects of Pingni decoction combined with anti-acid therapy in treating Liver Stomach Heat Accumulation Syndrome of laryngopharyngeal reflux disease(LPRD)accompanied with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 104 patients with a diagnosis of LPRD accompanied with OSAHS were selected.Patients were divided into group A(n=42),group B(n=38)and group C(n=24),randomly.Group A was treated with combination of Pingni decoction and PPI;group B was given Pingni decoction;group C was given PPI medication.Reflux symptom index(RSI),reflux finding score(RFS),and 24 hours resistence-pH values were collected and compared after 2 months,6 months with different treatment.Results Compared with prior treatment,group A,B and C observed significant therapeutic effects for all indexes(P<0.05),except for non-significant efficacy observed for non-acid reflux index(pH>7)for group C treatment.Better efficacy was observed with treatment after 6 months than 2 months(P<0.05).Statistics from index change percentage from the baseline of prior treatment measurement showed treatment A has a better therapeutic effect on RSI,RFS and acid-related reflux index(pH<7)than B,and A has better therapeutic effects on RSI,RFS and non-acid-related index(pH>7)than C.Conclusion Combination of Pingni decoction with PPI has better efficacy in improving the symptoms of LPRD associated with OASHS than single use of PPI treatment and Pingni decoction.

关 键 词：咽喉反流病(LPRD) 睡眠呼吸暂停低通气综合征(OSAHS) 反流症状指数(RSI) 反流体征评分(RFS) 24h阻抗-pH监测 平逆方 

分 类 号：R766[医药卫生—耳鼻咽喉科]