| Objective To investigate the effect of laryngeal reflux(LRP)on voice fatigue(VF)and the therapeutic effect of transcutaneous electrical acupoint stimulation(TEAS)on voice fatigue.Methods From the otolaryngology clinic of our hospital,60 patients with voice fatigue and 60 healthy adults were selected.Healthy adult age,height,weight,sex,history of alcohol and smoke,reflux symptom index(RSI),reflux finding score(RFS),and indirect laryngoscopy results were collected;Patients with voice fatigue were further collected from their occupation,mean total daily voice use,and electronic fiber laryngoscopy,and 24-hour Dx-p H monitoring was performed for patients with suspected laryngeal reflux.Subsequently,60 patients with voice fatigue were numbered according to their order of visit,and they were randomly divided into acupoint electrical stimulation group(referred to as group A)and voice training group(referred to as group B),with 30 cases in each group.Group B was treated with voice training and PPI drugs,and Group A was treated with percutaneous electrical stimulation of acupoints on the basis of Group B treatment,among which patients without laryngeal reflux were treated with Renying(RN22)and Tiantu(ST9)for electrical stimulation treatment,and patients with laryngeal reflux were treated with Renying(RN22),Tiantu(ST9)and Neiguan(PC6)for electrical stimulation treatment.and patients in both groups were treated for 8 weeks.The voice handicap index(VHI),voice fatigue index(VFI),voice hoarseness assessment form(GRBAS),RSI and RFS were recorded before and after the intervention were recorded,and the results of video laryngoscopy before and after the intervention and the subjective symptoms of patients were compared to determine the treatment efficacy.Results There was no significant comparison between the baseline data of age,sex,History of alcohol and smoke,body mass index(BMI)and other baseline data of patients with voice fatigue and healthy control group members(P>0.05).There were 34 patients with RSI>13 and/or RFS>7 among 60 patients with voice fatigue,and 28 patients with laryngeal reflux symptoms were finally diagnosed by Dx-PH monitoring,which was statistically significant compared with healthy adults(P<0.05).Among the patients with voice fatigue,the vast majority of them were forced to use their voices for a long time due to professional needs,and the occupational proportions were 13(21.67%)sales,13(21.67%)teachers,9(15.00%)self-employed,9(15.00%)company employees,6(10.00%)at home,5 anchors(8.33%)and 5(8.33%)factory workers.Twenty-two people used their voices for more than 6 hours a day,18 used their voices for about 4-5 hours a day,16 used their voices for at least 3-4 hours a day,and only 4 used their voices for less than 2 hours a day.There were no significant differences in pretreatment age,gender,History of alcohol and smoke,BMI,VHI-E,VHI-P,VHI-F,VFI Part 1,VFI Part 2,VFI Part 3,GRBAS-G,RSI,RF scores between the two groups with voice fatigue.After 8 weeks of treatment,the VHI-E,VHI-P,VHI-F,VFI Part 1,VFI Part 2,VFI Part 3,GRBAS-G,RSI and RFS scores were all improved compared with those before treatment,except for VHI-E,the comparison before and after treatment in the other observation groups was statistically significant(P<0.05).After 8weeks of treatment,the comparison between groups A and B showed that the voice score,RSI and RFS of group A were better than those of group B,but there were no significant statistical differences in the VFI scale parts 1 and 2,GRBAS-G and RFS scores.In addition,the overall effective rate of group A was significantly higher than that of group B(p<0.05).Conclusion The prevalence of throat reflux in the voice fatigue group was significantly higher than that in the healthy control group,and laryngeal reflux may be one of the causes of voice fatigue.Transcutaneous acupoint electrical stimulation not only has a good effect on the treatment of voice fatigue symptoms,but also has a certain effect on the treatment of laryngeal reflux,which is worthy of further multi-center and multi-sample clinical research and exploration. |
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