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嗓音治疗联合抑酸治疗可迅速恢复胃食管反流患者的嗓音相关症状。

Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients.

机构信息

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Otolaryngol Head Neck Surg. 2012 Jan;146(1):92-7. doi: 10.1177/0194599811422014. Epub 2011 Sep 9.

DOI:10.1177/0194599811422014
PMID:21908799
Abstract

OBJECTIVE

Patients with laryngopharyngeal reflux frequently experience voice-related symptoms. This study was designed to investigate the effectiveness of combined voice and medical therapy in comparison with medical therapy alone in the improvement of voice-related symptoms and parameters in patients with laryngopharyngeal reflux.

STUDY DESIGN

Concurrent nonrandomized comparative trial.

SETTING

Otolaryngology department at a university hospital.

SUBJECTS AND METHODS

In this prospective study, 100 patients diagnosed with laryngopharyngeal reflux with voice symptoms were divided into 2 groups: 50 patients were treated with medication alone, and 50 were treated with medication plus voice therapy. The following data were recorded before treatment and at 1, 2, and 3 months posttreatment: reflux symptom index (RSI), reflux finding score (RFS), voice handicap index (VHI), perceptual analysis, and acoustic analysis. The numbers of patients showing clinically significant reductions in these parameters were compared between groups using the following cutoff values: change in RSI ≥5, change in RFS ≥3, change in VHI ≥15, and change in grade, roughness, breathiness, asthenia, and strain scale (GRBAS) ≥1.

RESULTS

Significantly more patients in the study group showed a clinically significant change in RSI, VHI, and GRBAS score at the 1-, 2-, and 3-month follow-up evaluations. No clinically significant change in RFS was achieved in either group at 1 or 2 months, but a significantly greater change was achieved in the study group at 3 months.

CONCLUSIONS

Voice therapy may help to restore reversible mucosal change secondary to acidic reflux, inducing rapid resolution of symptoms and shortening of the treatment period.

摘要

目的

患有咽喉反流的患者常出现与声音相关的症状。本研究旨在比较联合嗓音与药物治疗与单纯药物治疗在改善咽喉反流患者的与声音相关的症状和参数方面的效果。

研究设计

同期非随机对照试验。

设置

大学医院耳鼻喉科。

受试者和方法

在这项前瞻性研究中,将 100 例被诊断为咽喉反流伴声音症状的患者分为 2 组:50 例接受单纯药物治疗,50 例接受药物加嗓音治疗。在治疗前以及治疗后 1、2 和 3 个月记录以下数据:反流症状指数(RSI)、反流发现评分(RFS)、嗓音障碍指数(VHI)、听觉分析和声学分析。使用以下临界值比较两组之间这些参数的临床显著减少的患者数量:RSI 变化≥5,RFS 变化≥3,VHI 变化≥15,以及等级、粗糙度、气息声、无力和紧张度量表(GRBAS)变化≥1。

结果

研究组在治疗后 1、2 和 3 个月的 RSI、VHI 和 GRBAS 评分的临床显著变化的患者比例显著更高。在治疗后 1 或 2 个月,两组的 RFS 均未出现临床显著变化,但研究组在 3 个月时的变化显著更大。

结论

嗓音治疗可能有助于恢复酸性反流引起的可逆转的黏膜变化,从而快速缓解症状并缩短治疗时间。

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