[目的]观察自拟调肝理脾利咽方治疗胃食管反流(GERD)相关咽喉反流病的临床疗效.[方法]采用前瞻、随机、对照的方法,选取2018年2月～2019年1月就诊于我院的62例GERD相关咽喉反流病患者,随机分为2组,试验组32例,对照组30例.试验组予调肝理脾利咽方十奥美拉唑肠溶片,对照组予奥美拉唑肠溶片,疗程4周.治疗后观察反流症状评分量表(reflux symptom index,RSI)、中医症状评分量表及随访复发情况.[结果]①RSI评分:2组在治疗2周、4周后RSI评分均降低(P＜0.05),治疗4周后试验组RSI评分低于对照组(P＜0.05).②咽喉反流主要症状:试验组治疗2周、4周后咽喉反流主要症状较前均改善(P＜0.05).对照组治疗2周后持续清嗓、饭后或躺下咳嗽、咽异物感、烧心或胸痛胃痛较前改善(P＜0.05),治疗4周后持续清嗓、饭后或躺下咳嗽、咽异物感、烧心或胸痛胃痛较前有改善(P＜0.05).治疗4周后组间比较咽异物感、烧心或胸痛胃痛评分差异有统计学意义(P＜0.05).③中医症状评分:2组在治疗2周、4周后中医症状评分均降低(P＜0.05),治疗4周后试验组中医症状评分低于对照组(P＜0.05).④中医疗效情况:治疗组总有效率为90.6％,对照组为66.7％,2组疗效情况差异有统计学意义(P＜0.05).⑤随访复发情况:停药4周后,试验组停药25例,复发重新服药7例;对照组停药21例,维持治疗3例,复发重新服药6例.停药患者中,试验组RSI评分低于对照组(P＜0.05),且对照组RSI评分较治疗4周后升高(P＜0.05).[结论]与单纯应用奥美拉唑治疗相比,调肝理脾利咽方联合奥美拉唑治疗GERD相关咽喉反流病有较好的临床疗效,且可降低其复发风险.

Gastroesophageal reflux disease(GERD) is a common disease of the digestive system,and throat discomfort is one of the main extra-esophageal manifestations.With the increasing incidence of GERD in China,the pathogenesis,diagnosis and treatment of GERD related pharynx-larynx diseases have gradually become the research hotspots,which has been emphasized by the Department of Gastroenterology and ENT.As the deepening of clinical research,people's understanding of the etiology,pathogenesis and diagnostic methods of GERD related pharynx-larynx diseases has been gradually improved.However,in the treatment of Western Medicine,inhibition of acid secretion with PPI is the main therapy.Traditional Chinese medicine,based on the traditional theory of TCM,has been gradually showing its advantages by syndrome differentiation and comprehensive treatment of causes and symptoms.