Junaid Montasir, Qadeer Ahmed Sadaf, Kazi Maliha, Khan Hareem U, Sohail Halim Muhammad
Otolaryngology - Head and Neck Surgery, Armed Forces Hospital Southern Region, Khamis Mushait, SAU.
Otolaryngology - Head and Neck Surgery, Sir Syed College of Medical Sciences, Karachi, PAK.
Cureus. 2020 Dec 21;12(12):e12195. doi: 10.7759/cureus.12195.
Introduction Laryngopharyngeal reflux (LPR) is a different entity from gastroesophageal reflux disease (GERD). Patients with LPR usually present with a variety of symptoms such as hoarseness, voice fatigue, burning sensation in the throat, persistent cough, sore throat, dysphagia, a sensation of a lump in the throat, and chronic throat clearing. The management of LPR is based on medications (proton pump inhibitors) along with lifestyle and dietary modifications. It has been suggested that the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) are useful parameters to assess patients with LPR. The aim of this study is to assess the subjective and objective benefits of RFS and RSI for diagnosing and management of LPR in the tertiary care center and to find the difference in RSI and RSI scoring with respect to gender. Methods A prospective study was performed and 102 patients were included according to inclusion criteria. RFS and RSI questionnaires were filled on the first visit of patients and then treatment with proton pump inhibitors was started along with lifestyle modification instructions. Questionnaires were filled after four weeks and then 12weeks post-treatment. Repeated measure analysis of variance (ANOVA) was performed to compare the mean RFS and RSI from baseline to the end of treatment. The post hoc analysis was done using the Bonferroni test of multiple comparisons. An independent sample t-test was also used to compare the mean RFS and RSI between genders. P-values less than 0.05 were considered statistically significant Results RFS and RSI were found to be significantly decreased post-treatment after four weeks and 12 weeks post-treatment (p-value- <0.01). Eight point eight percent (8.8%) side effects were observed in the study, the change in quality of life after a three-month treatment was significantly improved among 62.7% patients, and 75.5% did lifestyle modifications. In the mean comparison of RFS and RSI with respect to gender, it was observed that the mean RFS of females samples after one month and three months of treatment were significantly less as compared to male samples, p<0.01. There was no significant mean difference observed for RSI after one month and three months of treatment with respect to gender (p>0.05). Conclusion RFS and RSI are convenient and helpful for diagnosing LPR, and they can be easily implemented in ear, nose, throat (ENT) clinics for the subjective and objective assessment of LPR. Females showed greater improvement on laryngoscopy findings (RFS scores) post-treatment as compared to males.
引言 喉咽反流(LPR)是一种与胃食管反流病(GERD)不同的病症。LPR患者通常会出现多种症状,如声音嘶哑、声音疲劳、咽喉部烧灼感、持续性咳嗽、咽痛、吞咽困难、咽喉部异物感以及慢性清嗓。LPR的治疗基于药物(质子泵抑制剂)以及生活方式和饮食调整。有人提出反流症状指数(RSI)和反流发现评分(RFS)是评估LPR患者的有用参数。本研究的目的是评估在三级医疗中心RFS和RSI对LPR诊断和管理的主观和客观益处,并找出RSI和RFS评分在性别方面的差异。方法 进行了一项前瞻性研究,根据纳入标准纳入了102例患者。在患者首次就诊时填写RFS和RSI问卷,然后开始使用质子泵抑制剂治疗并给予生活方式调整指导。在治疗4周后以及治疗12周后再次填写问卷。进行重复测量方差分析(ANOVA)以比较从基线到治疗结束时的平均RFS和RSI。事后分析使用多重比较的Bonferroni检验。还使用独立样本t检验比较不同性别之间的平均RFS和RSI。P值小于0.05被认为具有统计学意义。结果 发现治疗4周后和治疗12周后RFS和RSI均显著降低(p值<0.01)。在研究中观察到8.8%的副作用,62.7%的患者在三个月治疗后生活质量的变化有显著改善,75.5%的患者进行了生活方式调整。在RFS和RSI关于性别的均值比较中,观察到治疗1个月和3个月后女性样本的平均RFS显著低于男性样本,p<0.01。治疗1个月和3个月后,关于性别,RSI未观察到显著的均值差异(p>0.05)。结论 RFS和RSI对于诊断LPR方便且有帮助,并且它们可以很容易地在耳鼻喉(ENT)诊所实施,用于LPR的主观和客观评估。与男性相比,女性在治疗后喉镜检查结果(RFS评分)方面显示出更大的改善。