| ObjectiveLaryngopharyngeal reflux disease(LPRD) refer to gastric contents through the upper esophageal sphincter retrograde motion to the throat, reserved in the throat abnormal, thus cause throat series of syndrome or histopathological changes. In recent years, more and more scholars found that LPR is a relatively special disease in chronic pharyngolaryngitis, on the etiology, symptoms and treatment has different characteristics. Chinese medicine has certain effect on treatment based on syndrome differentiation of LPR, however, the previous studies in the scientific nature and repeatability there are still insufficient, especially in the aspect of rules of syndrome.This study is based on the literature research of LPR, to develop a self-rating scale of LPR main syndrome characteristics and extent. Through the LPR patients clinical investigation, discuss distribution regularity of TCM syndrome characteristics and syndrome type, provide a preliminary basis for the clinical syndrome differentiation and treatment of LPR.MethodsAdopt the method of combining literature research and clinical investigation. Literature Search:Mainly to retrieve literature at home and abroad, discus this disease of TCM syndrome type distribution characteristics, and establish a syndrome scale for LPR syndrome, clinical research:To investigate 195 patients with LPR syndrome scale, explore the related factors and differentiation. Performs a statistical analysis on the data, discuss the TCM etiopathogenisis and pathogenesis, distribution character-istic of TCM syndrome.Results1. Literature search:arrange for 42 papers, there were 12 types of syndrome of LPRD, including the syndrome of ineoordination between the liver and stomach (29.63%), the syndrome of weakness of the spleen and the stomach (18.52%), the syndrome of liver depression and spleen deficiency (3.70%), the syndrome of splenogastric hygropyrexia(9.26%), the syndrome of cold-heat jumble (8.33%), the syndrome of Stomach Yin deficiency (12.04%), the syndrome of Qi stagnation and blood stasis (4.63%), the syndrome of liver and stomach gloomy heat type (5.56%), the syndrome of Phlegmy wet resistance (3.70%), the syndrome of exuberance of stomach fire (1.85%), the syndrome of Phlegm hot accumulate knot (1.85%), the syndrome of Gallbladder heat make stomach (0.93%). This disease mainly location in the stomach, liver, spleen, lung, and gallbladder, kidney also has certain correlation with the disease.2. Clinical investigation(1)The onset age, gender, course and related factors:In the incidence of gender there is no significant difference. Pacients aged 18-35 account for the largest proportion. Patients aged 36-50 account for the second lagest proportion. Patients aged 51-65 account for the least Proportion. The course of disease below 6 months account for the lagest Proportion. The course of disease among 1-5 years account for the second lagest Proportion. The course of disease among 6 months to lyear and 5-llyears are Relatively rare. Major cause of the disease for tobacco and alcohol addiction, dietary factors and Emotional factors, also have part of the patients have no obvious cause.(2)The major clinical symptoms of LPRD:The common clinical manifestations of the disease is pharyngeal foreign body sensation, belching, Acid reflux, phlegm, hawk, cough, gasteremphraxis, searing pain after the sternum, dry throat, hoarseness, postnasal drip, pharyngalgia.(3)The tongue picture and pulse of LPRD:red tongue or dark tongue, moss thin white, pulse string is most common. Prompt the close relations with factors of liver depression, qi stagnation, heat.(4)TCM syndrome type distribution of LPRD:There are 7 syndromes of LPRD in clinieal observation. The syndrome of ineoordination between the liver and stomach (34.36%), the syndrome of liver depression and spleen deficiency (22.56%), the syndrome of weakness of the spleen and the stomach (14.36%), the syndrome of liver and stomach gloomy heat type (10.26%), the syndrome of splenogastric hygropyrexia (8.72%), the syndrome of stomach Yin deficiency (5.64%), the syndrome of Qi stagnation and blood stasis (4.10%). The syndrome of ineoordination between the liver and stomaeh are the most in sthenia syndrom.the syndrome of weakness of the spleen and the stomach are the most in asthenia syndrome. The syndrome of liver depression and spleen deficiency are the most in the syndrome with asthenia and sthenia.(5)The relationship between RSI, RFS and TCM syndrome:RSI total score have statistically significant difference between the syndrome of liver depression and spleen deficiency and the syndrome of weakness of the spleen and the stomach(P<0.05). The syndrome of weakness of the spleen and the stomach and the syndrome of splenogastric hygropyrexia, the syndrome of Stomach Yin deficiency the syndrome of splenogastric hygropyrexia comparison were statistically significant in RFS total score (P<0.05)Conclusion1. Different syndrome types of the distribution of age, course of the disease has obvious difference, but no gender difference.2. The main syndromes in the literature researeh is the same with the result of clinical observation. There was some difference of distribution.The distribution regularity of syndromes of LPR in clinical observation are:the syndrome of ineoordination between the liver and stomach> the syndrome of liver depression and spleen deficiency>the syndrome of weakness of the spleen and the stomach> the syndrome of liver and stomach gloomy heat>the syndrome of splenogastric hygropyrexia>the syndrome of stomach Yin deficiency>the syndrome of Qi stagnation and blood stasis.3. The syndromes distribution of LPR are syndromes mainly in state of evil domination, the second are syndromes mainly in state of asthenia of healthy energy, the third are syndromes mainly instate of deficiency and excess with the same severity occurring at the same time. The most common syndromes, tongues and pulse of LPR have close relationship with liver, spleen and stomach.4. The rule of the syndromes distribution of LPR according to RSI and RFS score show the disease develop in TCM. At the early stage of disease, there are syndromes mainly in state of evil domination. The syndrome of ineoordination between the liver and stomach and the syndrome of liver and stomach gloomy heat account for mainly proportion. At the development stage5.of the disease, there are syndromes mainly in state of deficiency and excess. The syndrome of liver depression and spleen deficiency and the syndrome of splenogastric hygropyrexia account for mainly proportion. With the further development of the disease, there are syndromes mainly in state of asthenia of healthy energy. The syndrome of weakness of the spleen and the stomach and the syndrome of stomach Yin deficiency account for mainly proportion. |
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