【摘要】：目的:通過總結(jié)探討胃食管反流病(Gastroesophageal reflux disease,GERD)合并咽感異�；颊叩陌l(fā)病危險(xiǎn)因素及質(zhì)子泵抑制劑(Proton pump inhibitor,PPI)治療效果,從而提高臨床醫(yī)師對(duì)GERD合并咽感異常發(fā)病危險(xiǎn)因素與治療的認(rèn)識(shí)。方法:搜集皖南醫(yī)學(xué)院第一附屬醫(yī)院消化內(nèi)科門診在2015年10月-2016年10月就診的167例GERD合并咽感異�；颊叩呐R床資料,以具有典型的胸骨后燒灼感(燒心)、反流癥狀,且內(nèi)鏡檢查示反流性食管炎(reflux esophagitis,RE)合并咽感異常,或者有典型的胸骨后燒灼感(燒心)、反流癥狀,內(nèi)鏡未見食管黏膜破損,且胃食管反流病問卷(GERD questionnaire,GredQ)評(píng)分≥8分合并咽感異�；颊邽閷�(shí)驗(yàn)組,并以我院體檢中心167例非GERD體檢者為對(duì)照組,進(jìn)行如下內(nèi)容調(diào)查:基本情況(主訴、性別、年齡、聯(lián)系方式、體重、身高、腹圍)采集、疾病因素和生活習(xí)慣(有無頸椎病、精神心理因素異常和有無飲用濃茶、吸煙、飲酒史)、反流癥狀指數(shù)量表(Reflux symptomindex,RSI)、反流癥狀積分量表、胃食管反流病問卷(GERD questionnaire,GerdQ)、醫(yī)院焦慮抑郁量表(hospital anxiety and depression scale,HADS)調(diào)查,分析GERD合并咽感異�；颊叩陌l(fā)病危險(xiǎn)因素;對(duì)實(shí)驗(yàn)組患者進(jìn)行PPI治療:雷貝拉唑10mg BID口服,4周后對(duì)其進(jìn)行隨訪,再次行反流癥狀積分量表調(diào)查,分析PPI治療效果。結(jié)果:實(shí)驗(yàn)組中男性72例,女性95例,年齡19-78歲,平均(48.0±16.50)歲,對(duì)照組中男性83例,女性84例,年齡20-76歲,平均(50.5±16.01)歲;GERD合并咽感異�；颊咧醒屎矸戳餍约膊∮�118例,單純咽感異常者有49例,其中,118例咽喉反流性疾病中精神心理因素異常(焦慮/抑郁)者占34.7%(41/118),49例單純咽感異常中精神心理因素異常(焦慮/抑郁)者占63.2%(31/49),兩者差異有統(tǒng)計(jì)學(xué)意義(χ2=11.482,P=0.001);可以得出精神心理因素異常(焦慮/抑郁)可能在GERD患者出現(xiàn)咽感異常癥狀中發(fā)揮重要作用;年齡、腹圍、體重指數(shù)(Body mass index,BMI)、頸椎病、精神心理因素異常(焦慮/抑郁)是GERD合并咽感異�；颊叩陌l(fā)病危險(xiǎn)因素(P0.05),且腹圍(OR,2.311;95%置信區(qū)間,1.382至3.865)和頸椎病(OR,1.890;95%置信區(qū)間,1.064至3.354)是其獨(dú)立危險(xiǎn)因素,而性別、吸煙、飲酒及飲濃茶與其發(fā)病無明顯相關(guān)性(P0.05)。GERD合并咽感異常的167例患者PPI治療結(jié)果示:治療前癥狀積分2-9分,平均(6.50±1.77)分,治療后癥狀積分0-9分,平均(2.79±1.72)分,治療前后反流癥狀積分行配對(duì)設(shè)計(jì)t檢驗(yàn)統(tǒng)計(jì)分析(t=28.693,p0.001)差異有統(tǒng)計(jì)學(xué)意義,并且有效者有79例,顯效者有39例,無效者有49例,總有效率為71.7%。結(jié)論:年齡、腹圍、體重指數(shù)增加和合并頸椎病、精神心理因素異常是GERD合并咽感異�；颊叩陌l(fā)病危險(xiǎn)因素,且腹圍和頸椎病是其獨(dú)立危險(xiǎn)因素,而性別、吸煙、飲酒、飲濃茶與其發(fā)病無明顯相關(guān)性。精神心理因素異�？赡茉贕ERD患者出現(xiàn)咽感異常癥狀中發(fā)揮重要作用,PPI治療GERD合并咽感異常患者的治療總有效率較高。
[Abstract]:Objective: to investigate the risk factors of gastroesophageal reflux disease (Gastroesophageal reflux disease,GERD) with abnormal pharynx sensation and the efficacy of proton pump inhibitor (Proton pump inhibitor,PPI) in the treatment of gastroesophageal reflux disease (GERD). So as to improve the clinician's understanding of the risk factors and treatment of GERD complicated with abnormal pharynx sensation. Methods: the clinical data of 167 patients with GERD complicated with abnormal pharynx sensation were collected from the Department of Gastroenterology of the first affiliated Hospital of Southern Anhui Medical College from October 2015 to October 2016 in order to have typical symptoms of posterior sternal burning (heartburn) and reflux. And endoscopy showed that reflux esophagitis (reflux esophagitis,RE) complicated with abnormal pharyngeal sensation, or had typical retrosternal burning (heartburn), reflux symptoms, no esophageal mucosal damage in endoscopy, and gastroesophageal reflux disease questionnaire (GERD questionnaire,). GredQ) score 鈮，

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