Gelardi M, Silvestri M, Ciprandi G
Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
Istituto G. Gaslini, Genova, Italy
J Biol Regul Homeost Agents. 2018;32(1 Suppl. 2):9-19.
Laryngopharyngeal Reflux (LPR) should be considered as part of extraesophageal reflux (EER). This reflux involves respiratory structures other than, or in addition to, the oesophagus. A new medical device for the treatment of gastric reflux, including LPR, has been launched in Italy: Marial®. Therefore, the aim of the present survey was to analyse the prescriptive behaviour both considering the past or current treatments and clinical features during a specialist routine visit. The current survey was conducted in 86 Otorhinolaryngological centers, distributed in all of Italy. Globally, 4.418 subjects [47% males and 53% females, 50.1 (14.5) years-of-age] were visited. The visits included laryngoscopy, Reflux Finding Score (RFS) and Reflux Symptom Index (RSI) questionnaires. The total RSI median score was 15 (12-19) and the total median RFS value was 10 (8-12). Interestingly, a significant change in the new drug prescription was observed (p<0.0001): over two-third of patients (67%) received Marial® as monotherapy, whereas PPI plus add-on were prescribed to almost one-third of the patients. PPI alone was prescribed in less than 1%. In conclusion, LPR is a common disorder characterized by typical signs and symptoms; LPR patients may be correctly identified and scored by evidence-based criteria. In addition, the present survey reported that LPR treatment has been considerably changed by the introduction of a new medical device.
喉咽反流（LPR）应被视为食管外反流（EER）的一部分。这种反流涉及食管以外或除食管之外的呼吸结构。一种用于治疗包括LPR在内的胃反流的新型医疗器械已在意大利推出：Marial®。因此，本次调查的目的是分析在专科常规就诊期间，考虑过去或当前治疗方法以及临床特征的处方行为。本次调查在意大利各地分布的86个耳鼻喉科中心进行。全球范围内，共诊治了4418名受试者[男性占47%，女性占53%，年龄为50.1（14.5）岁]。就诊包括喉镜检查、反流发现评分（RFS）和反流症状指数（RSI）问卷。RSI总中位数评分为15（12 - 19），RFS总中位数评分为10（8 - 12）。有趣的是，观察到新药处方有显著变化（p<0.0001）：超过三分之二的患者（67%）接受Marial®作为单一疗法，而近三分之一的患者被处方使用质子泵抑制剂（PPI）加附加药物。仅开具PPI的患者不到1%。总之,LPR是一种具有典型体征和症状的常见疾病；LPR患者可以通过循证标准正确识别和评分。此外，本次调查表明，一种新型医疗器械的引入使LPR治疗发生了很大变化。
