Pepsin Assay For Diagnosis And Treatment Evaluation Of Laryngopharyngeal Reflux

Patients with the symptoms of dry pharynx, globus pharyngeus, excessive throat clearing, chronic cough account a large proportion in the ENT clinic. Doctors ruled out chronic tonsillitis, styloid process syndrome, throat cancer, and systemic disease, often diagnosed as chronic pharyngitis and giving appropriate treatment. But very often, patients treated by medication can not reach satisfactory outcome, or disease can not be cure completely. Long-term drug treatment but poorly, patients feel highly psychological burden and economic pressures. Sometimes side effects may also lead to functional impairment in patients with the body.With the continuous development of healthcare, diagnosis and treatment technology, people gradually realize that a reflux disease: laryngopharyngeal reflux, LPR. Its pathogenesis, disease conditions, reflux pattern, clinical features, treatment methods and many other aspects are very different from gastroesophageal reflux, GER. Large number of foreign clinical studies have found that the incidence of laryngopharyngeal reflux is not low, patients with pharyngeal paresthesia symptoms, pronunciation problems, sleep disorders, respiratory function are almost have high relationship with laryngopharyngeal reflux. For example, international research has become a hot issue in interstitial edema, laryngeal stenosis, laryngeal contact granuloma, laryngeal cancer and other diseases. But in comparison, people's understanding of hypopharyngeal reflux was not enough, and lack of convenient and reliable diagnostic method. No uniform diagnostic criteria, clinical diagnosis is often delayed or result in misdiagnosis, leading to failure treatment symptoms of pharyngeal paresthesia. Recently, some scholars suggested the throat sputum / saliva testing of pepsin can be used as an effective, non-invasive, objective laryngopharyngeal reflux detection methods, but few such studies internally. Therefore, this clinical trials is though pepsin detection method of throat sputum to determine the value and efficacy of laryngopharyngeal reflux diagnosis, and by the reflux symptom table and the reflux finding table to evaluate the clinical significance of screening. So as to laryngopharyngeal reflux and chronic pharyngitis theoretical basis for clinical diagnosis was established. This experimental choosing thirty-six patients with the symptoms of dry pharynx,globus pharyngeus, excessive throat clearing, chronic cough were divided into laryngopharyngeal reflux group and chronic laryngitis group by the results of therapeutic trial taking proton pump inhibitors(PPI) for 3 months .The estimation of the reflux symptom index (RSI), the reflux finding score (RFS) and the detection of pepsin in the sputum were done before and after the treatment. The difference between two groups and the value of the pepsin were analyzed. 123 patients were divided into hypopharyngeal reflux group (29 cases) and chronic pharyngitis (94 cases) according to effective treatment. The reflux symptom table and the reflux finding table were all statistically analyzed and compared between the two groups.The results are showed as follows:1. Pepsin level in the sputum might be used as a objective,effective method for diagnosing and evaluating the effectiveness in laryngopharyngeal reflux.2. Diagnostic treatment, combined with The reflux symptom table and the reflux finding table is an effective diagnostic method of laryngopharyngeal reflux which is suitable for all levels of the hospital.