反流症状指数和反流发现评分能否用于指导成人分泌性中耳炎的治疗？
Can Reflux Symptom Index and Reflux Finding Score Be Used to Guide the Treatment of Secretory Otitis Media in Adults?
机构信息
Department of Otolaryngology, Kaifeng Hospital of Traditional Chinese Medicine, Kaifeng, China.
Department of Otolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
出版信息
ORL J Otorhinolaryngol Relat Spec. 2020;82(3):130-138. doi: 10.1159/000505929. Epub 2020 Jan 15.
BACKGROUND
At present more attention is paid to the treatment of secretory otitis media in children, but there is also a high incidence of adult patients. The etiology of secretory otitis media in adults is complex and related to many factors.
OBJECTIVES
The aim of this study was to evaluate the correlation between the Reflux Symptom Index (RSI)/Reflux Finding Score (RFS) and secretory otitis media in adults, and to explore further treatment methods.
MATERIAL AND METHODS
Taking outpatients in the otology department from January 2017 to May 2019 as the object of study, acoustic immittance tests were performed and the results analyzed. Patients with secretory otitis media received tympanocentesis or tympanotomy and the related components were analyzed.The patients were followed up and the curative effects of different treatment schemes were compared.
RESULTS
There were 67 patients with secretory otitis media. The prevalence of secretory otitis media in patients with RSI >13 was significantly higher than that in patients with RSI <13. The prevalence of secretory otitis media in patients with RFS >7 was significantly higher than that in patients with RFS <7 (p < 0 05). The RSI/RFS score of B tympanogram was significantly higher than that of A and C maps (p < 0.05). Among the patients with type B, the serous type was higher in those with an RSI score <13, and the mucus was higher in those with an RSI score >13 (p < 0.05). There was no significant difference in the proportion of glue patients (p > 0.05). In type B patients, the detection rate of pepsin in the experimental group was significantly higher than that in the control group (p < 0.05), and the scores of RSI/RFS in the pepsin-positive group were significantly higher than those in the negative group (p < 0.05). Treatment with acid-suppressive drugs in patients with abnormal RSI/RFS achieved better results (p < 0.05).
CONCLUSIONS
RSI/RFS may be related to the development of secretory otitis media in adults, and could play a guiding role in its treatment.
背景
目前，人们更加关注儿童分泌性中耳炎的治疗，但成人患者的发病率也很高。成人分泌性中耳炎的病因复杂，与多种因素有关。
目的
本研究旨在评估反流症状指数（RSI）/反流发现评分（RFS）与成人分泌性中耳炎的相关性，并探讨进一步的治疗方法。
材料和方法
以 2017 年 1 月至 2019 年 5 月耳鼻喉科门诊患者为研究对象，进行声导抗测试并分析结果。对分泌性中耳炎患者进行鼓膜穿刺或鼓膜切开术，并分析相关成分。对患者进行随访，比较不同治疗方案的疗效。
结果
共 67 例分泌性中耳炎患者。RSI>13 的患者分泌性中耳炎患病率明显高于 RSI<13 的患者，RFS>7 的患者分泌性中耳炎患病率明显高于 RFS<7 的患者（p<0.05）。B 型鼓室图的 RSI/RFS 评分明显高于 A 型和 C 型图（p<0.05）。在 B 型患者中，RSI 评分<13 的患者中浆液型较高，RSI 评分>13 的患者中黏液型较高（p<0.05）。胶耳患者比例无显著差异（p>0.05）。在 B 型患者中，实验组胃蛋白酶的检出率明显高于对照组（p<0.05），胃蛋白酶阳性组的 RSI/RFS 评分明显高于阴性组（p<0.05）。异常 RSI/RFS 患者应用抑酸药物治疗效果较好（p<0.05）。
结论
RSI/RFS 可能与成人分泌性中耳炎的发生有关，可对其治疗起到指导作用。
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