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反流症状指数和反流发现评分在喉咽反流管理中的实用性。

Usefulness of the Reflux Symptom Index and Reflux Finding Score in the Management of Laryngopharyngeal Reflux.

作者信息

Puttamadaiah G M, Naik Prithvi

机构信息

Department of Otorhinolaryngology, Bangalore Medical College and Research Institute, Bangalore, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5170-5175. doi: 10.1007/s12070-024-04920-4. Epub 2024 Aug 3.

Abstract

Laryngopharyngeal reflux (LPR) refers to a condition in which gastroduodenal contents reflux back into the oesophagus and affects the throat, specifically the laryngopharynx. A wide variety of symptoms have been attributed to LPR. To minimize the underdiagnosis, Reflux Symptom Index (RSI) with the Reflux Finding Score(RFS) are useful in ENT practice. LPR treatment typically entails an intensive strategy, applied over an extended period of time, combined with dietary adjustments, exercise, weight loss and lifestyle changes. To study the usefulness of Reflux Symptom Index and Reflux Finding Score in the management of LPR. This study was a descriptive study conducted in the Department of ENT, Bangalore Medical College and Research Institute, Bangalore from February 2021 to August 2022. This study included 90 patients who were diagnosed to have LPR attending the ENT OPD at Bangalore Medical College and Research Institute, Bangalore and attached hospitals. All patients were subjected to detailed history taking using RSI, thorough clinical examination and laryngoscopic examination using RFS and necessary investigation was done. They were treated with proton pump inhibitors and prokinetic drugs and followed up regularly. Treatment was stopped after 6 months to prevent long-term adverse. Our study recruited 90 patients who were diagnosed to have LPR of which 55 were male and 35 female. Most of them were 41-50 years of age. Throat clearing was found to be the most common symptom and erythema/ hyperaemia of larynx was the most common sign. It was found that median RSI score was highest at baseline (13) and lowest 2 months (2) with no RSI score at 3 and 6 months. The median RFS scores was highest at baseline (8) and lowest after 2 months (1) with no RFS score at 3rd and 6th months. The difference was statistically significant. Major improvement in symptoms was seen after 2nd month and major improvement in laryngoscopic signs was seen after 1st month. RSI and RFS are useful diagnostic tools in identifying patients with LPR. It helps in assessing response to treatment during their follow up. Treatment with proton pump inhibitors and prokinetic drugs along with strict dietary modification, stress management and regularization of life style has to be followed for a duration of 6 months with regular follow up for complete resolution of signs and symptoms.

摘要

喉咽反流(LPR)是指胃十二指肠内容物反流至食管并影响咽喉,特别是喉咽部的一种病症。多种症状都被归因于喉咽反流。为尽量减少漏诊情况,反流症状指数(RSI)和反流发现评分(RFS)在耳鼻喉科实践中很有用。喉咽反流的治疗通常需要一种强化策略,在较长时间内应用,并结合饮食调整、运动、体重减轻和生活方式改变。为研究反流症状指数和反流发现评分在喉咽反流管理中的作用。本研究是一项描述性研究,于2021年2月至2022年8月在班加罗尔医学院和研究所的耳鼻喉科进行。本研究纳入了90例被诊断为患有喉咽反流的患者,他们在班加罗尔医学院和研究所及附属医院的耳鼻喉科门诊就诊。所有患者均使用RSI进行详细的病史采集,进行全面的临床检查,并使用RFS进行喉镜检查,同时进行必要的检查。他们接受质子泵抑制剂和促动力药物治疗,并定期随访。6个月后停止治疗以预防长期不良反应。我们的研究招募了90例被诊断为患有喉咽反流的患者,其中55例为男性,35例为女性。他们大多年龄在41至50岁之间。清嗓被发现是最常见的症状,喉部红斑/充血是最常见的体征。结果发现,RSI中位数评分在基线时最高(13分),在2个月时最低(2分),在3个月和6个月时无RSI评分。RFS中位数评分在基线时最高(8分),在2个月后最低(1分),在第3个月和第6个月时无RFS评分。差异具有统计学意义。症状在第2个月后有显著改善,喉镜体征在第1个月后有显著改善。RSI和RFS是识别喉咽反流患者的有用诊断工具。它有助于在随访期间评估治疗反应。必须使用质子泵抑制剂和促动力药物,并严格进行饮食调整、压力管理和生活方式规律化,持续6个月,并定期随访以完全消除体征和症状。

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1
Prevalence of Laryngopharyngeal Reflux Disease in Indian Population.印度人群中喉咽反流病的患病率
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1877-1881. doi: 10.1007/s12070-020-01882-1. Epub 2020 May 20.
3
Assessment of treatment response in patients with laryngopharyngeal reflux.喉咽反流患者治疗反应的评估
Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):77-80. doi: 10.1007/s12070-016-1046-5. Epub 2017 Jan 3.

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