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目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例患者均行24 h 咽喉 pH检测,筛选出阳性患者作为试验组接受奥美拉唑抗酸治疗;第二组25例患者直接给予相同药物及剂量的试验性抗酸治疗作为对照组。服药3个月后进行随访,根据反流症状评分对比治疗前后效果,以主观症状评估总分下降≤4分为治疗无效,>4分为有效。结果行24 h 咽喉 pH 检测的25例患者中有病理性咽喉部反流者17例,阳性率为68.0%(17/25)。24 h 平均总反流次数(35.71±41.70)次(±s,以下同),总反流时间(35.71±33.19)min,总反流指数即每小时反流次数(1.53±1.73)次/h,每次反流平均时间(1.12±0.91)min。抗酸治疗前试验组症状评估总分平均(14.88±4.11)分,对照组总分平均(13.00±4.17)分,组间差异采用 t 检验,无统计学意义(P>0.05)。在抗酸治疗3个月后随访,试验组有效率为82.4%(14/17),对照组失访2例,其余患者治疗有效率为52.2%(12/23)。试验组症状评估总分平均下降(7.47±3.18)分,对照组症状评估总分下降(3.96±4.25)分,总分差值比较,差异有统计学意义(P<0.01)。结论 24 h 咽喉 pH 检测作为诊断咽喉反流性疾病的金标准,可以作为临床中可疑咽喉反流患者的确诊检查手段,并可大大提高抗酸治疗的有效性,值得在临床普遍开展和推广。
Objective To investigate the value of 24 h throat pH in the diagnosis of throat reflux disease. Methods Fifty patients with suspicious reflux disease were diagnosed in Beijing Tongren Hospital from August to October in 2006. The patient’s consent was based on the time of visiting for compatibility. According to the randomized block arrangement method, a semi-random Grouping. The first group of 25 patients underwent 24 h pharyngeal pH test, screening out positive patients as experimental group receiving omeprazole antacid therapy; the second group of 25 patients directly given the same drug and dose of antacid therapy as a control group. After 3 months of medication, follow-up was conducted. According to the reflux symptom score, the effect of treatment before and after treatment was compared. Results Twenty-seven patients with pathologic throat reflux in 25 patients who underwent 24 h pharyngeal pH test had a positive rate of 68.0% (17/25). 24 h mean total reflux (35.71 ± 41.70) times (± s, the same below), total reflux time (35.71 ± 33.19) min, total reflux index (1.53 ± 1.73) times / h , The average time of each reflux (1.12 ± 0.91) min. The total scores of symptom assessment in the experimental group before antacid treatment were 14.88 ± 4.11 and 13.00 ± 4.17 in the control group, respectively. There was no significant difference between the two groups (P> 0.05). At 3 months after antacid therapy, the effective rate was 82.4% (14/17) in the experimental group and 2 (12.2%) in the control group. The total score of symptom assessment decreased by 7.47 ± 3.18 in the experimental group, and decreased by 3.96 ± 4.25 in the control group. There was significant difference between the two groups (P <0.01). Conclusion The 24 h pharyngeal pH test, as the gold standard for the diagnosis of throat reflux disease, can be used as a diagnostic test for patients with suspected throat reflux and can greatly enhance the effectiveness of antacid therapy. It is worthy of being widely used in clinical practice.