摘要
【目的】探究慢性喉炎中医证型分布与嗓音障碍指数(VHI-10)及反流症状指数(RSI)评分和反流体征评分(RFS)的相关性。【方法】回顾性分析100例慢性喉炎患者的临床资料和中医证型分布情况,所有患者在完善电子鼻咽喉镜和/或动态喉镜后,由2位主治医师以上耳鼻喉科医生根据患者喉部体征进行RFS评分,最终结果取平均值;患者在医师的指导下对自身不适情况进行自评,填写VHI-10和RSI量表。最终将结果汇总至Excel表格中建成数据库,并用SPSS 23.0软件进行统计学分析。【结果】(1)100例慢性喉炎患者中,RSI>13分和/或RFS>7分者34例;VHI-10平均得分为(14.30±9.05)分,RSI平均得分为(9.77±6.04)分,RFS平均得分为(5.78±1.78)分;VHI-10与RSI、RFS相关性系数分别为0.383(P<0.001)和-0.016(P>0.05),RSI与RFS相关性系数为0.101(P>0.05)。(2)100例慢性喉炎患者中,气虚痰结证9例(9.0%)、痰浊结聚证18例(18.0%)、痰气交阻证24例(24.0%)、气虚痰湿瘀阻证11例(11.0%)、痰瘀互结证25例(25.0%)、气滞血瘀痰凝证13例(13.0%)。(3)中医证型与VHI-10得分相关性系数为0.593(P<0.05),与RSI得分相关性系数为0.318(P<0.01),与RFS相关性系数为0.015(P>0.05)。【结论】慢性喉炎的诊疗中需考虑反流因素;在慢性喉炎的患者中,症状与体征并不完全相符,诊疗过程中同时应用VHI-10、RFS及RSI量表,能更全面了解慢性喉炎患者是否存在咽喉反流以及反流的严重程度;在纳入研究的患者中,辨证均以气、痰、瘀为主,并兼杂气虚等,且中医证型分布与VHI-10有中度相关性。
Objective To investigate the correlation of the distribution of traditional Chinese medicine(TCM)syndromes of chronic laryngitis with voice handicap index(VHI-10), reflux symptom index(RSI)scores and reflux finding scores(RFS). Methods Clinical data and TCM syndrome distribution of 100 patients with chronic laryngitis were retrospectively analyzed. After all of the patients received the fiber-optic nasolaryngoscopy and/or dynamic laryngoscopy, RFS scores were evaluated by two or more attending otolaryngologists according to the findings of the patients’ larynx, and the final results were averaged. Under the guidance of physicians, the patients made self-assessment of their discomforts,and filled in VHI-10 and RSI scales. Finally,the results were input to Excel to build a database,and then SPSS 23.0 software was used for statistical analysis. Results(1)Of the 100 patients with chronic laryngitis,34 patients had RSI scores > 13 and/or RFS scores > 7. The mean scores of VHI-10,RSI and RFS were(14.30 ± 9.05),(9.77 ± 6.04)and(5.78 ± 1.78)respectively. The correlation coefficients of VHI-10 with RSI and RFS were 0.383(P<0.001)and-0.016(P>0.05)respectively. The correlation coefficient between RSI and RFS was 0.101(P>0.05).(2)Among the 100 patients with chronic laryngitis,there were 9 cases(9.0%)of qi deficiency and phlegm stagnation syndrome,18 cases(18.0%)of accumulation of phlegm and turbidity syndrome, 24 cases(24.0%) of blockage of phlegm blended with qi syndrome,11 cases(11.0%)of qi deficiency with blockage of phlegm-damp and blood stasis syndrome,25 cases(25.0%)of phlegm blended with blood stasis syndrome,and 13 cases(13.0%)of qi stagnation,blood stasis and phlegm accumulation syndrome.(3)The correlation coefficient of TCM syndromes with VHI-10 scores, RSI scores,and RFS was 0.593(P<0.05),0.318(P<0.01)and 0.015(P>0.05),respectively. Conclusion The reflux factor should be considered in the diagnosis and treatment of chronic laryngitis. The symptoms and signs are not completely consistent in the patients with chronic laryngitis. Moreover,the application of VHI-10,RFS and RSI scales in the diagnosis and treatment of chronic laryngitis can provide a more comprehensive understanding of the existence of laryngeal reflux in the patients with chronic laryngitis and the severity of reflux. In the patients who were included in the study,the syndrome element differentiation is predominated by qi,phlegm and blood stasis,and characterized by the complication of qi deficiency, and the distribution of TCM syndromes is moderately correlated with VHI-10.
作者
吴国晶
陈文勇
WU Guo-Jing;CHEN Wen-Yong(Dept.of Otolaryngology Head and Neck Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2021年第11期2306-2312,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省李云英名中医传承工作室建设项目(编号:粤中医办函[2017]17号)。
关键词
慢性喉炎
中医证型
嗓音障碍指数
反流症状指数评分
反流体征评分
相关性
chronic laryngitis
traditional Chinese medicine(TCM)syndrome types
voice handicap index(VHI-10)
reflux symptom index(RSI)scores
reflux finding score(RFS)
correlation
