| Objective:This study analyzed the influence of cauterization on different clinical manifestations of chronic tonsillitis,evaluated the changes in quality of life,and calculated the recurrence rate 3 months after treatment,in order to better develop appropriate treatment plans for patients with different complaints,namely,"according to the symptoms",and provide a basis for further promotion of tonsil cauterization.Methods:A total of 90 patients with chronic tonsillitis from the Department of Otolaryngology and Head and Neck Surgery(including Dongge Hospital and Xianxi Hospital)of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from March 2020 to June 2021 were collected as the research objects.Each clinical presentation(Symptoms: sore pharynx,dry pharynx,itchy pharynx,foreign body sensation in the pharynx,irritating cough,bad breath and undescribable discomfort;physical signs: Tonsil enlargement,tonsil congestion,tonsil scar,abscess supposition,palatal arch congestion and adhesion,neck lymphatic enlargement,etc.)Visual analog scores(VAS),WHO Quality of Life Inventory(WHOQOL-BREF)before treatment,3months,6 months and 12 months after treatment,combined with outpatient or telephone follow-up for recurrence,The recurrence rate in 3months was calculated.The data were systematically sorted out,the relevant database was established,and SPSS 22.0 statistical software was used for statistical processing.Results:(1)A total of 90 patients with chronic tonsillitis meeting the study requirements was collected in this study,including 44 males,accounting for 48.89% of the cases and 46 females,accounting for51.11% of the total cases.The subjects ranged in age from 18 to 58 years old,with an average age of 37.89 ± 12.83 years old.The course of disease ranged from 1 to 10 years,with an average course of 2.74 ± 5.19 years.(2)The clinical manifestations of patients with chronic tonsillitis are mostly double clips,and the distribution according to the proportion of components is successively as follows: Foreign body sensation of the pharynx(79 cases,87.78%)> sore pharynx(73 cases,81.11%)> dry pharynx(69 cases,76.67%)> itching of the pharynx(68 cases,75.56%)> irritating dry cough(55 cases,61.11%)> bad breath(45 cases,50.00%)> undescribed discomfort(26 cases,28.89%).Physical signs:Tonsil mucous hyperemia(81 cases,90.00%)> tonsil enlargement(74cases,82.22%)> tonsil scar(55 cases,61.11%)> palatal arch hyperemia and adhesion(47 cases,52.22%)> pus supposition(31 cases,34.44%)>other(14 cases,15.56%)> neck lymph node enlargement(10 cases,11.11%).(3)In 90 patients with chronic tonsillitis,after a course of cautery treatment,3 months later,the evaluated curative effect reached the clinical recovery of 1 case(1.11%),the obvious effect of 6 cases(6.67%),effective 64 cases(71.11%),19 cases(21.11%),recovery rate of 7.78%,the total effective rate of 78.89%;after 6 months,3 cases(3.33%)were cured,28 cases(31.11%)were effective,49 cases(54.44%)were effective and 10 cases(11.11%)were ineffective.The total recovery rate was 34.44% and the total effective rate was 88.89%.After 12 months,13 cases(14.44%)were cured,43 cases(47.78%)were effective,29cases(32.22%)were effective,and 5 cases(5.56%)were ineffective.The recovery rate was 62.22% and the total effective rate was 94.44%.No adverse reactions occurred in all patients during treatment.(4)After 1 course of treatment,the overall clinical manifestations of all patients were decreased,P < 0.05,indicating that the differences were statistically significant.Among them,the difference before and after symptom score in descending order was as follows: foreign body sensation of the pharynx > sore pharynx > itching pharynx > irritant dry cough > bad breath > undescribable discomfort;In descending order,the difference between scores of the tonsil related signs was as follows: tonsil enlargement > tonsil mucous congestion > tonsil scar > palatal arch congestion and adhesion > pus supposition > cervical lymph node enlargement > others.(5)The median total score of quality of life of 90 subjects was 67.36 before treatment,and increased to 72.39 in 12 months after treatment.The difference was significant because P< 0.05.Among them,the median score of the physiological field increased from 10.56 to 12.85,the median score of the psychological field increased from 10.82 to 12.93,and the median score of environmental and social relations field showed no significant difference before and after treatment.(6)At the third month after the end of the first course of treatment,a total of 7 people had reached clinical recovery and obvious effect.At the next visit 12 months later,1 person reached the standard of relapse,and the recurrence rate was 14.29%.Conclusion :(1)Tonsil cauterization is effective in the treatment of chronic tonsillitis,and the total effective rate increases gradually with the extension of observation time.After 12 months of treatment,the total effective rate reaches 94.44%.It is especially suitable for the patients with the main manifestations of "foreign body sensation in the pharynx,pharyngeal pain,and swollen tonsils",while it is not effective for the patients with the main manifestations of "irritant dry cough,bad breath and swollen neck lymph nodes." Overall,signs improved more than symptoms.(2)Chronic tonsillitis has an impact on the quality of life of patients,which is mainly reflected in the physiological and psychological fields.After cautery treatment,the quality of life has been improved,with obvious physiological and psychological improvement.(3)The recurrence rate of chronic tonsillitis patients who achieved clinical recovery and obvious effect in 3 months after cautery treatment was 14.29% after observation for 1 year,and longer-term data need to be further observed. |
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