| Objective:Patients with GERD and RH with laryngopharyngeal symptoms were differentiated into different types.High-resolution esophageal manometry and intra-esophageal multichannel impedance combined with pH monitoring were used to study the characteristics of different syndromes and the differences in esophageal function among different syndromes.Methods:the object of study for January 2019-January 2021 in the Beijing Chinese medicine hospital affiliated to the capital university of medical sciences,inpatient and outpatient patients,according to the RSI scale,RFS scale,electronic gastroscope,esophageal pressure and 24-hour pH impedance monitoring results,collected 219 patients,including a total of 79 patients with throat symptoms of GERD and a total of 140 patients with throat symptoms of RH.General information and clinical symptoms were collected,and syndrome differentiation was carried out.Results:1.Comparison of general data:the age and BMI of GERD group with laryngopharyngeal symptoms were significantly higher than those of RH patients with laryngopharyngeal symptoms(P<0.05).Pressure in RH group with laryngopharyngeal symptoms was significantly higher than that in GERD group(P<0.05).The occupational difference between GERD group and RH group with laryngopharyngeal reflux was statistically significant(P<0.05).The number of smokers in GERD group with laryngopharyngeal reflux was significantly higher than that in RH group(P<0.05).GERD and RH with laryngopharyngeal symptoms had no statistical significance in gender,course of disease,education level,frequency of eating out every week,speed of eating,whether eating is full,drinking and hiatal hernia(P>0.05).2.Distribution of TCM syndromes:A total of 219 patients were included in this study,including 79 patients in GERD group and 140 patients in RH group.Among them,GERD group had 16 cases(20.25%)of stagnation of heat in liver and stomach,24 cases(30.38%)of bile heat affecting stomach,29 cases(36.71%)of spittoon obstruction,7 cases(8.86%)of middle deficiency of qi and 3 cases(3.80%)of dampness-heat of spleen deficiency.In the RH group,36 cases(25.71%)of stagnation heat in liver and stomach,41 cases(29.29%)of bile heat affecting stomach,38 cases(27.14%)of spittoon obstruction,19 cases(13.57%)of middle deficiency of qi and 6 cases(4.29%)of dampness-heat of spleen.There was no statistical significance in TCM syndromes between the two groups(P<0.05).3.Comparison of esophageal function between western medicine groups:?Esophageal pressure:the percentage of ineffective swallowing in RE group with laryngopharyngeal symptoms was significantly higher than that in RH group(P<0.05).The differences of RE,NERD and RH with laryngopharyngeal symptoms in other esophageal sphincter function,esophageal contractility and esophageal motor coordination were not statistically significant(P>0.05).?Reflux condition:presenting with symptoms of throat RH group in DeMeester score,total reflux time,total number of reflux,long reflux times,reflux time longest,percentage of total acid exposure,percentage of standing acid exposure,percentage of decubitus acid exposure,distal acid reflux times,proximal acid reflux times is significantly below RE number group,the NERD group(P<0.05),The number of distal reflux in RH group was significantly lower than that in RE group(P<0.05).There was no statistical significance in the number of distal weak acid reflux,distal non-acid reflux,proximal reflux,proximal weak acid reflux and proximal non-acid reflux among the three groups(P>0.05).4.Comparison of esophageal function in different syndromes of two diseases:?Esophageal pressure:The mean amplitude of bile heat invading stomach group was significantly lower than that of liver and stomach heat suppressing group,qi stagnation and phlegm blocking group and middle deficiency and qi inversion group(P<0.05).The percentage of normal peristalsis in the bile heat invading stomach group was significantly lower than that in the middle deficiency qi inversion group(P<0.05).The percentage of ineffective swallowing in the bile heat invading stomach group was significantly higher than that in the middle deficiency qi inversion group(P<0.05).There was no statistical significance in other esophageal sphincter function,esophageal contractility and esophageal motor coordination among different syndromes(P>0.05).?Reverse flow situation:There was no significant difference in reflux among different syndromes(P>0.05).5.Comparison of esophageal functions in different types of the same disease:? In the GERD group with laryngopharyngeal symptoms,the resting pressure of LES in the spleendeficiency damp-heat group was significantly higher than that in the other four groups(P<0.05).There was no statistical significance in other esophageal sphincter function,esophageal contractility and esophageal motor coordination among different syndromes(P>0.05).The total reflux time and total acid exposure time in liver and stomach heat suppression group was significantly higher than that in medium deficiency qi inversion group(P<0.05).The number of proximal acid reflux in liver and stomach heat stagnation group was significantly higher than that in spittoon crossblock group(P<0.05).The number of proximal acid reflux in bile fever group was significantly higher than that in spittoon obstruction group(P<0.05).There was no statistical significance in residual reflux among different syndromes(P>0.05).? RH group with pharyngopharyngeal symptoms:The percentage of peristalsis in the bile fever group and the spittoon obstruction group was significantly lower than that in the middle deficiency qi inversion group(P<0.05).The percentage of ineffective swallowing in the bile heat invading stomach group was significantly higher than that in the middle deficiency qi inversion group(P<0.05).There was no statistical significance in other esophageal sphincter function,esophageal contractility and esophageal motor coordination among different syndromes(P>0.05).There was no significant difference in reflux among different syndromes(P>0.05).Conclusion:Esophageal function varies with TCM syndromes.?The esophageal contractile force of GERD and RH patients with laryngopharyngeal symptoms with gastric syndrome caused by bile fever decreased significantly compared with other syndromes.?GERD patients with heat stagnation syndrome of liver and stomach have more severe acid reflux and wider lesion range.There is a certain correlation between TCM syndrome differentiation and objective indexes of western medicine. |
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