Hanson D G, Kamel P L, Kahrilas P J
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, Chicago, IL 60611, USA.
Ann Otol Rhinol Laryngol. 1995 Jul;104(7):550-5. doi: 10.1177/000348949510400709.
This study examined outcomes of antireflux and antacid treatment for the signs and symptoms of chronic laryngitis. Patients from a referral institutional practice with chronic laryngitis symptoms, without other apparent causes of laryngeal inflammation, were followed up and examined at progressive stages of antireflux treatment as a case series outcome study. The cases included unselected individuals with a diagnosis of chronic (> 3 months' duration) laryngitis. Patients with chronic throat complaints were treated with nocturnal antireflux precautions, with addition of famotidine 20 mg or omeprazole 20 mg at bedtime for patients who did not respond to antireflux precautions alone. The outcome measures were resolution of symptoms, and change in findings on telescopic laryngoscopy. Chronic throat symptoms of 93 of 182 patients (51%) responded to nocturnal antireflux precautions alone. The complaints of an additional 48 patients resolved with the addition of famotidine 20mg at bedtime to antireflux precautions (77% response). The symptoms of 34 of the remaining 41 patients responded to treatment with omeprazole 20 mg at bedtime. Therefore, symptoms of 96% of patients responded to treatment aimed at preventing reflux of gastric acid. The remaining patients with refractory symptoms had a partial response or no response or chose fundoplication. Erythema and granular mucositis were the most common laryngoscopic findings. Ulceration and granuloma formation were less common, but also responded to antireflux treatment. Some (7) patients required high doses of omeprazole or fundoplication to achieve symptomatic relief and healing of chronic inflammatory changes of the posterior larynx. Relapse of symptoms was common when treatment was stopped.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究考察了抗反流和抗酸治疗对慢性喉炎体征和症状的疗效。以病例系列结果研究的方式，对来自一家转诊机构、患有慢性喉炎症状且无其他明显喉部炎症病因的患者，在抗反流治疗的不同阶段进行随访和检查。病例包括未经挑选、诊断为慢性（病程超过3个月）喉炎的个体。有慢性咽喉不适的患者采取夜间抗反流预防措施，对于单独采取抗反流预防措施无效的患者，睡前加用20毫克法莫替丁或20毫克奥美拉唑。观察指标为症状的缓解情况以及间接喉镜检查结果的变化。182例患者中有93例（51%）的慢性咽喉症状仅对夜间抗反流预防措施有反应。另外48例患者在抗反流预防措施基础上加用睡前20毫克法莫替丁后症状得到缓解（缓解率77%）。其余41例患者中有34例的症状对睡前服用20毫克奥美拉唑治疗有反应。因此，96%的患者症状对旨在预防胃酸反流的治疗有反应。其余难治性症状患者有部分反应或无反应，或选择了胃底折叠术。红斑和颗粒状黏膜炎是最常见的喉镜检查结果。溃疡和肉芽肿形成较少见，但对抗反流治疗也有反应。一些（7例）患者需要高剂量奥美拉唑或胃底折叠术才能实现症状缓解以及喉后部慢性炎症改变的愈合。停止治疗后症状复发很常见。（摘要截选至250词）
