Objective To investigate the etiological diagnosis of chronic cough with pharyngitis-like manifestations. Methods Patients with chronic cough and pharyngitis-like manifestations were recruited from Outpatient Department of Guangzhou Institute of Respiratory Diseases between December 2002 to March 2010. The causes of chronic cough were investigated using a well-established diagnostic protocol, including history taking and physical examination, pulmonary function tests, induced sputum cytology, 24-h esophageal pH monitoring, etc. The final diagnosis depended on clinical manifestations, examination findings, and a successful response to therapy. Results 326 patients with chronic cough and pharyngitislike manifestations were included in the study with amedian duration of 24 ( 2 ～480) months, amean age of 41 ±13 years. The causes of chronic cough were identified as follows: post nasal drip syndrome or upper airway cough syndrome in 73 cases ( 23. 31% ) , cough variant asthma in 61 cases( 18. 71% ) , eosinophilic bronchitis in 70 cases( 22. 47% ) , gastroesophageal reflux-induced cough in 54 cases ( 16. 56% ) , atopiccough in 48 cases ( 14. 72% ) , and others in 40 cases ( 12. 27% ) . There is no significant difference in percentage of common causes of chronic cough ( P gt; 0. 05) . Conclusion The proportions of upper airway syndrome and other common causes are similar in chronic cough with pharyngitis-like manifestatioins, whichsuggest pharyngitis-like manifestations are not specific for diagnosis of upper airway cough syndrome.
【摘要】目的 比较复方中药金喉健和庆大霉素超声雾化吸入治疗急性咽炎的疗效。方法 2003年3月2006年5月急性咽炎患者200例,分为金喉健组100例和庆大霉素组100例,分别用金喉健和庆大霉素注射液配合地塞米松注射液进行超声雾化吸入治疗,1次/d,连续治疗7 d。治疗前后进行临床和实验室检查,观察疗效和安全性。结果金喉健和庆大霉素超声雾化吸入治疗急性咽炎的疗效无差异。结论金喉健雾化吸入治疗急性咽炎疗效显著,无毒副作用。
ObjectiveTo explore and analyze the clinical diagnosis and treatment of gastroesophageal reflux disease (GERD) which is manifested mainly as stubborn pharyngitis. MethodsFrom February 2010 to December 2012, 79 cases were diagnosed as stubborn pharyngitis and otolaryngology standard treatment was invalid. GERD questionnaire ratings and conventional endoscopy were performed for patients with obvious manifestations of stubborn pharyngitis shown on the laryngoscopy. They were randomly divided into treatment group (n=40) and control group (n=39). Patients in the treatment group accepted esomeprazole 40 mg, qd, for 12 weeks; and patients in the control group had sucralfate suspension 15 mL bid for 12 weeks. At the three observation points which are 4, 8, and 12 weeks after treatment began, clinical symptom score and pharyngeal inflammatory changes were recorded, and at the end of the treatment, all patients underwent endoscopy, and esophageal mucosal healing was observed. ResultsThere was no significant difference between the two groups of patients in terms of general data. After the treatment, the symptom scores were significantly decreased in the treatment group at the three observation points (P<0.05). The same situation happened also in the control group, but the difference was not significant (P>0.05). The symptom scores between the two groups after treatment were significantly different (P<0.5). And the effective rate for local pharyngeal infection was 83.9% and 41.4% in the treatment group and the control group respectively (P<0.05). ConclusionSome atypical GERDs feature by the symptoms of stubborn pharyngitis. Clinically, patients with long-term stubborn pharyngitis should be screened to exclude the possibility of GERD. esomeprazole therapy can significantly improve the pharyngitis symptoms and relieve local inflammation.
Acute pharyngitis belongs to the category of “acute throat impediment” in traditional Chinese medicine (TCM), which has a high incidence and is easy to recur. In clinical practice of TCM, Chinese patent medicines with the effects of clearing heat and detoxifying, reducing swelling and relieving pain are widely used in the treatment of acute pharyngitis. These medicines have the advantages of definite efficacy, low side effects, and low risk of developing drug resistance. However, at present, there are no standardized clinical diagnostic and therapeutic evaluation norms for acute pharyngitis in TCM, which has hindered the application of TCM in the prevention and treatment of acute pharyngitis and the development of new TCM preparations. Therefore, the China Association of Chinese Medicine initiated this expert consensus, which was led the formulation by Xiyuan Hospital, China Academy of Chinese Medical Sciences. This expert consensus integrates the current best evidence and extensive clinical expert experience from the front line, covering seven aspects: applicable scope, diagnosis in both Chinese and Western medicine, syndrome classification and evaluation scales, basis for efficacy evaluation, and time for efficacy evaluation. It has formed 8 types of TCM syndromes for acute pharyngitis, as well as the diagnostic criteria, syndrome classification and evaluation scales, evaluation basis for efficacy, and scoring standards for syndromes and diseases. This expert consensus can be used to standardize the diagnosis of the TCM syndromes of acute pharyngitis, as well as the core indicators and evaluation methods for syndrome and disease efficacy, with the aim of providing references for clinical practice and scientific research on acute pharyngitis.