上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

星状神经节阻滞对反流性咽喉炎的疗效研究

赵辉1,2,金晓杰1,2   

  1. 上海交通大学医学院 1.附属仁济医院南院耳鼻咽喉科， 上海 201112； 2.附属仁济医院耳鼻咽喉科， 上海 200127
  • 出版日期:2015-12-28 发布日期:2016-01-21
  • 通讯作者: 金晓杰, 电子信箱: jinxiaojie@renji.com。
  • 作者简介:赵辉（1983—）， 男， 住院医师， 硕士; 电子信箱: zhaohui18926@163.com。

Study on the effect of stellate ganglion block on the treatment of laryngopharyngeal reflux

ZHAO Hui1,2, JIN Xiao-jie1,2   

  1. 1.Department of Otolaryngology, RenJi Hospital South Campus， Shanghai Jiao Tong University School of Medicine， Shanghai 201112， China； 2.Department of Otolaryngology, RenJi Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200127， China
  • Online:2015-12-28 Published:2016-01-21

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摘要：

目的  研究星状神经节阻滞对反流性咽喉炎的治疗效果。方法  依据咽喉反流症状指数量表（RSI）及体征评分量表（RFS）筛选出90名反流性咽喉炎患者,并随机分为质子泵抑制剂治疗组（PPI组）和星状神经节阻滞治疗组（SGB组），每组45例。PPI组予每日口服雷贝拉唑20 mg，治疗8周；SGB组予1%利多卡因5mL行星状神经节阻滞，每周1次，连续8周；分别4周和8周后再次填写RSI和RFS量表，比较每组治疗前后评分差别和两组间的评分差别。结果  PPI组治疗4周后RSI与RFS评分分别为15.45±5.05和8.35±1.92，与治疗前相比差异无统计学意义（P>0.05）。SGB组RSI与RFS评分分别为12.32±4.02和 8.48±1.65，其中RSI评分与治疗前相比有差异有统计学意义（P<0.05）。SGB组与PPI组相比RSI评分减小，差异有统计学意义（P<0.05）。治疗8周后PPI组RSI与RFS评分分别为9.02±3.34和8.12±2.05；RSI评分与治疗前相比减小，差异有统计学意义（P<0.01）。SGB组RSI与RFS评分分别为8.85±3.62和6.17±1.22；与治疗前相比，RSI与RFS评分均减小，差异有统计学意义（P<0.01， P<0.05）。治疗8周后SGB组与PPI组RSI评分相比差异无统计学意义（P>0.05）；RFS评分相比SGB组比PPI组减小，差异有统计学意义（P<0.05）。结论  SGB对反流性咽喉炎是一种安全有效的治疗方法，尤其在治疗的早期效果上，甚至要优于PPI。

关键词: 喉咽反流, 胃食管反流, 星状神经节阻滞

Abstract:

Objective  To investigate the effect of stellate ganglion block (SGB) on the treatment of patients with laryngopharyngeal reflux(LPR). Methods  Ninety patients were enrolled according to Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) and randomly divided into stellate ganglion block group (SGB group, n=45) and proton pump inhibitor group (PPI group, n=45). Patients of PPI group were orally administrated with 20 mg of PPI for 8 weeks. Patients of SGB group underwent SGB by 5 mL lidocaine (1%) for 8 weeks, once a week. Scores of RSI and RFS 4 and 8 weeks after treatment were recorded. The differences of scores of each group and between every two groups before and after treatment were compared. Results  After 4 weeks of treatment, the scores of RSI and RFS of PPI group were 15.45±5.05 and 8.35±1.92, respectively. The differences of scores of RSI and RFS before and after treatment were not statistically significant (P>0.05). The scores of RSI and RFS of SGB group were 12.32±4.02 and 8.48±1.65, respectively. The differences of scores of RSI before and after treatment were statistically significant (P<0.05).Compared with PPI group, the scores of RSI of SGB group decreased and the differences were statistically significant (P<0.05). After 8 weeks of treatment, the scores of RSI and RFS of PPI group were 9.02±3.34 and 8.12±2.05, respectively. The scores of RSI decreased compared with those before treatment and the differences were statistically significant (P<0.01). The scores of RSI and RFS of SGB group were 8.85±3.62 and 6.17±1.22, respectively. The scores of both RSI and RFS decreased compared with those before treatment and the differences were statistically significant (P<0.01，P<0.05). After 8 weeks of treatment, the differences of scores of RSI of SGB group and PPI group were not statistically significant (P>0.05). Compared with PPI group, the scores of RFS of SGB group decreased and the differences were statistically significant (P<0.05). Conclusion  SGB is a safe and effective method for the treatment of LPR. Especially at the early stage of treatment, the therapeutic effect of SGB is even better than that of PPI.

Key words: laryngopharyngeal reflux, gastroesophageal reflux, stellate ganglion block