Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy.
Laryngology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).
Acta Otorhinolaryngol Ital. 2024 Feb;44(1):27-35. doi: 10.14639/0392-100X-N2742.
The aim of this study was to compare the efficacy of voice therapy combined with standard anti-reflux therapy in reducing symptoms and signs of laryngopharyngeal reflux (LPR).
A randomised clinical trial was conducted. Fifty-two patients with LPR diagnosed by 24 h multichannel intraluminal impedance-pH monitoring were randomly allocated in two groups: medical treatment (MT) and medical plus voice therapy (VT). Clinical symptoms and laryngeal signs were assessed at baseline and after 3 months of treatment with the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Voice Handicap Index (VHI) and GRBAS scales.
Groups had similar scores at baseline. At 3-month follow-up, a significant decrease in RSI and RFS total scores were found in both groups although it appeared to be more robust in the VT group. G and R scores of the GRBAS scale significantly improved after treatment in both groups, with better results in the VT group. The VHI total score at 3 months improved more in the VT group (VHI delta 9.54) than in the MT group (VHI delta 5.38) (p < 0.001).
The addition of voice therapy to medications and diet appears to be more effective in improving treatment outcomes in subjects with LPR. Voice therapy warrants consideration in addition to medication and diet when treating patients with LPR.
本研究旨在比较嗓音治疗联合标准抑酸治疗对减轻咽喉反流（LPR）症状和体征的疗效。
进行了一项随机临床试验。52 例经 24 h 多通道腔内阻抗-pH 监测诊断为 LPR 的患者被随机分为两组：药物治疗（MT）和药物加嗓音治疗（VT）。在基线和治疗 3 个月后，使用反流症状指数（RSI）、反流发现评分（RFS）、嗓音障碍指数（VHI）和 GRBAS 量表评估临床症状和喉部体征。
两组基线评分相似。在 3 个月的随访中，两组的 RSI 和 RFS 总分均显著下降，尽管 VT 组的下降更为明显。两组的 GRBAS 量表的 G 和 R 评分在治疗后均显著改善，VT 组的效果更好。VT 组的 VHI 总分在 3 个月时改善更多（VHI 差值 9.54），而 MT 组的 VHI 差值为 5.38（p < 0.001）。
在药物和饮食治疗的基础上增加嗓音治疗似乎能更有效地改善 LPR 患者的治疗效果。在治疗 LPR 患者时，除药物和饮食外，嗓音治疗也值得考虑。
