Siupsinskiene Nora, Uloza Virgilijus, Pribuisiene Rūta, Butkus Evaldas, Kupcinskas Limas
Department of Otorhinolaryngology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(10):832-9.
The aim of this article is to introduce Lithuanian clinical practice guidelines for the management of laryngopharyngeal form of gastroesophageal reflux disease for standardization of the diagnosis and treatment of the disease and prevention of its complications. Composed guidelines provide recommendations for primary care physicians as well as otorhinolaryngologists and gastroenterologists for the management of adults with uncomplicated laryngopharyngeal form of gastroesophageal reflux disease. Committee composed of experts from Lithuanian Otorhinolaryngological and Gastroenterological Societies developed guidelines based on a comprehensive review of the evidence-based literature related to laryngopharyngeal form of gastroesophageal reflux disease and guidelines of other countries. The guidelines provide description of each medicine groups with emphasis on proton pump inhibitors as the most effective drugs for the treatment of laryngopharyngeal form of gastroesophageal reflux disease. Indications for empirical treatment with proton pump inhibitors are described, as well as duration of treatment, doses, optimal regimen of use, and assessment of treatment efficacy. The therapy should begin with the application of proton pump inhibitors twice daily, before meal for three months. Combined therapy for nonresponders is described. Algorithm for stopping the medication is recommended. These recommendations may provide an efficient and economical approach to the management of this problem.
本文旨在介绍立陶宛关于胃食管反流病咽喉部型管理的临床实践指南，以实现该疾病诊断和治疗的标准化并预防其并发症。所制定的指南为初级保健医生以及耳鼻喉科医生和胃肠病学家提供了针对患有非复杂性胃食管反流病咽喉部型成人患者管理的建议。由立陶宛耳鼻喉科和胃肠病学协会的专家组成的委员会，在全面回顾与胃食管反流病咽喉部型相关的循证文献及其他国家指南的基础上制定了这些指南。指南对各类药物进行了描述，重点强调质子泵抑制剂是治疗胃食管反流病咽喉部型最有效的药物。描述了质子泵抑制剂经验性治疗的适应证、治疗持续时间、剂量、最佳使用方案以及治疗效果评估。治疗应从每日两次在餐前服用质子泵抑制剂开始，持续三个月。还描述了对无反应者的联合治疗。推荐了停药算法。这些建议可能为该问题的管理提供一种高效且经济的方法。
