金喉雾化剂促进声带息肉术后嗓音功能恢复的临床研究
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摘要
目的:
     本研究旨在通过对声带息肉切除术后患者采用金喉雾化剂雾化吸入治疗与西药(地塞米松+庆大霉素)雾化吸入治疗相对比,观察中药制剂金喉雾化剂对声带息肉切除术后嗓音功能恢复的疗效,为声带息肉术后嗓音功能的恢复提供一种新的治疗方法。
     方法:
     收集2010年10月-2011年9月期间在广东省中医院耳鼻喉科行住院手术治疗的声带息肉患者共计100例,术后按照1:1的比例随机分为试验组(金喉组)与对照组(西药组),试验组予其口服维生素C片100mg,3次/日,并配合金喉雾化剂雾化吸入治疗,每日2次;西药组予其口服维生素C片100mg,每日3次,同时配合地塞米松+庆大霉素雾化吸入治疗,每日2次,共2周。治疗2周后分别比较患者治疗前后症状、体征、基频微扰、振幅微扰、噪声能量、谐噪比、平均基频(Hz)、最长声时(s)、嗓音障碍指数等的变化。西药组治疗前与治疗2周后的比较采用配对t检验,中药组治疗前与治疗2周后的比较采用配对t检验。西药组与中药组治疗前、治疗两周后各项指标比较采用两独立样本的t检验。所有的统计分析经过SPSS17.0软件进行。检验水准α=0.05。
     结果:
     1.试验组与对照组治疗后症状(声音嘶哑、咽干灼热、咽部异物感、清嗓习惯、痰、咳嗽)、体征(声带颜色、声带边缘、声带闭合)、嗓音声学分析(Jitter Shimmer HNR、NNE、平均基频、最长声时)、嗓音障碍指数(VHI-10)与治疗前相比差异有统计学意义(P<0.05);
     2.试验组治疗后与对照组治疗后相比较,症状、体征、嗓音声学数据、嗓音障碍指数均没有统计学差异(P>0.05)。结论:
     1.金喉雾化剂与西药在治疗声带息肉术后嗓音功能恢复方面有相同的疗效,应用于声带息肉术后嗓音功能恢复的治疗中,可以有很好的活血祛瘀散结,化痰清热消肿的作用,可以促进声带息肉术后嗓音功能的恢复,应该在声带息肉的临床治疗中推广应用。
     2.嗓音科学检查和嗓音障碍指数可以更加准确的地反映声带息肉术后患者嗓音功能恢复的客观及主观方面的情况,也可以为今后的临床及科研提供充足的数据,可以更加广泛地应用到声带疾病的临床检查中。
Objective
     Through the patients after resection of vocal polypus,the study aimed to make a comparison between the methods of gold throat atomization agent and western medicine (dexamethasone+gentamicin), observe the effect of gold throat atomization agent on voice function recovery after resection of vocal polypus, and provide a new treatment for the vocal polyps voice function restore.
     Methods
     We collected one hundred patients who have a treatment with vocal polypus in guangdong province traditional chinese medical hospital during october2010-september2011, according to the1:1ratio, then they were assigned into experimental group and control group. The patients of experimental group need oral Vitamin C100mg three times a day, and cooperate with golden throat spray agent aerosol inhalation of treatment two times a day; the patients of control group need oral Vitamin C100mg three times a day, and cooperate with dexamethasone+gentamicin atomization inhalation in the treatment two times a day. The treatment keep2weeks. After2weeks'treatment, compared the symptoms, signs, Jitter, Shimmer, HNR, NNE, F0, MPT, the VHI-10and so on between before and after treatment. The western medicine group and Chinese medince group are both apply the t test method for inspection before treatment and2weeks after treatment. They use two independent samples to test each index before treatment and after treatment of two weeks. All the statistical analysis by SPSS17.0. Inspection standard α=0.05.
     Results
     1. Before and after treatment between the experimental group and control group, there is remarkable statistically meaning for patients with symptoms (hoarseness, dryness of throat, pharyngeal foreign Body Sensation, throat clearing habit, phlegm, cough),signs (the color of the vocal cords, the edge of voice, the closing of the voice), the voice data (Jitter, Shimmer, HNR, NNE, F0,MPT) and VHI-10(P<0.05).
     2. After treatment between the experimental group and control group, there is not statistically meaning for the differences of symptoms, signs, the voice data and VHI-10(P>0.05)
     Conclusion
     1.The Golden throat spray agent have the same curative effect in voice recovery of Vocal cords polyps surgery with the Western medicine, can be used as a treatment for the vocal polyps voice function restore, have a very good effect of invigorating blood circulation, eliminating the lump, reduce heat and dissolve sputum, can promote the recovery of Voice function and reduce the recurrence rate. The Golden throat spray agent should devote more effects to using in the clinical.
     2. The examination of Voice and VHI-10can reflect the objective and subjective aspecte about vocal cords polyps postoperative more clearly, can provide enough data for clinical and Scientific research, should be used to check the Vocal cords diseases more widely.
引文
[1]黄冬雁,杨伟炎,于萍等.声带息肉发病危险因素的病例对照调查[J].听力学及言语疾病杂志,2008,16(1):42-45.
    [2]沈小华,温武,周水淼等.电子喉镜下常见喉病的诊断和手术治疗[J].第二军医大学学报,2000,21(12):1124-6.
    [3]李雅芳等.声嘶2162例临床分析[J].中国中西医结合耳鼻喉科杂志,1999,7(4):189-190.
    [4]吴跃军,欧小毅,王蜀英.声嘶500例纤维喉镜检查的临床分析[J].泸州医学院学报,2000,23(4):319—320.
    [5]M Stuart Strong MD, CW Vaughan MD, Boston Mass. Vocal cord nodules and polyps-the role of surgical treatment[J]. Laryngoscope,1971,81(6):911-23.
    [6]Wansa SA, Jones NS, Watkinson J. Unusual laryngeal cyst[J]. Laryngol Otol,1990,104: 145-6.
    [7]Marc Bouchyer MD, Guy Cornut, MD, Eduard Witzig MD, et al. Epidermoid cysts, sulci, and mucosal bridges of the true vocal cord:a report of 156 cases[J]. Laryngoscope,1985, 95:1087-94.
    [8]叶青,杨毓梅,赵舒薇等.支撑喉镜声带息肉术后嗓音恢复的声学观察[J].临床耳鼻咽喉科杂志,2002,16(4):172-3.
    [9]Hirano M, Hirade Y, Yoshide T, et al. Improved surgical technique for epidermoid cysts of the vocal fold[J]. Ann Otol Rhinol Laryngol,1989,98:791-5.
    [10]Woo P, Casper J, Colton R, et al. Diagnosis and treatment of persistent dysphonia after laryngeal surgery:a retrospective analysis of 62 patients[J]. Laryngoscope 1994,104: 1084-91.
    [11]ARIA会议.变应性鼻炎对哮喘的影响(ARIA)[C].首都儿科研究所哮喘防治与教育中心译,2001,95.
    [12]王士云,黄志纯,冯旭等,雾化吸入普米克令舒应用于声带息肉术后疗效观察[J].海南医学,2007,18(11),58-59.
    [13]薛明,房江滨,宋学章等.普米克在声带息肉术后的应用[J].中国中西医结合耳鼻咽喉科杂志,2002,10(6),285-286.
    [14]周卫东,李继红,王晓萍等.布地奈德雾化治疗应用于声带息肉术后[J].中华现代耳鼻喉科杂志,2005,2(2),173.
    [15]王士云,黄志纯,冯旭.雾化吸入普米克令舒应用于声带息肉术后疗效观察[J].海南医学,2007,18(11),58-59.
    [16]吴虹等.布地奈德混悬液雾化吸人在声带息肉患者术后的治疗护理观察[J].哈尔滨医药.2008,28(3),72.
    [17]李靖厚,桑蕊,刘艳武等.508例声嘶病人的临床分析[J].白求恩医科大学学报,1999,25(4):472.
    [18]任萍,全永安,周萍等.380声嘶病人动态喉镜检查结果分析[J].1998,19(4):282.
    [19]Sirikci A, Karatas E, Durucu C, et al. Noninvasive assessment of benign lesions of vocal folds by means of ultrasonography[J]. Ann Otol Rhinol Laryngol,2007,116:827 —831.
    [20]孔维佳.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2005,249-251.
    [21]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学(第2版)[M].北京:人民卫生出版社,2010,444.
    [22]胡顺临,林华,陈瑜萍.复方丹参注射液超声雾化吸人治疗声带息肉的疗效观察[J].中医杂志,1997,38(11):681-682.
    [23]李云英,黄穗平.声带结节、息肉与中医血瘀证治研究近况[J].中国中西医结合耳鼻喉科杂志,1996,4(4):196-198.
    [24]王东方,曹济航,覃都安.声带息肉患者甲皱微循环和组织病理观察及其与血瘀证关系探讨[J].中国中西医结合杂志,1995;15(9);522.
    [25]王东方,覃都安.声带息肉的舌诊及血液流变与血瘀关系的探讨[J].辽宁中医杂志,1995;22(10):433;
    [26]刘蓬.四诊资料探讨声带息肉与小结同血瘀的关系[J].中国中西医结合耳鼻喉科杂志,1998,6(3):129-131.
    [27]胡远宾.鼻内窥镜在支撑喉镜下手术治疗声带息肉及小结的应用[J].内蒙古医学杂志,2007,39(6):742.
    [28]林晓江,何本.支撑喉镜下鼻内窥镜治疗声带息肉与小结[J]. zhejiang practical Medicion August,2002,7 (4):236.
    [29]林天明.纤维支气管镜下切除声带息肉的体会[J].中华综合临床医学杂志,2004,6(3):88.
    [30]张春莉.经胃镜治疗声带息肉126例临床体会[J].中国社区医师,2011,13(284):155.
    [31]李业伟,卢宇玲.电子胃镜下微波治疗声带小结与息肉[J].中国新医药,2004,3(8):57.
    [32]余志能,张华.不同人路下声带息肉微波治疗的结果比较.新疆医科大学学报2008,31(8):1023-1025.
    [33]徐开伦,邓晓奕,刘宁恒.电视监视下纤维鼻咽喉镜手术治疗声带息肉、小结95例[J].临床耳鼻咽喉科杂志,2000,14(2);69.
    [34]吴波,林尚轩.纤维喉镜下声带息肉、小结切除术130例[J].临床耳鼻咽喉科杂志,1998,12(7);329—330.
    [35]胡亿文,张奇峰.支撑喉镜下射频治疗广基型声带息肉疗效观察[J].国际医药卫生导报,2003,9(5):48-49.
    [36]吴孝江,范良清.支撑喉镜下低温等离子射频消融术治疗声带良性病变200例体会[J]. Journal of Audiology and Speech Pathology,2008,16 (1):68.
    [37]宗小娜,张旭,王锦玲.纤维喉镜下射频治疗声带小结/息肉173例[J].第四军医大学学报,2001,,2(15):1377.
    [38]廖瑜等.直流电离子导入结合超短波治疗声带息肉激光术后水肿1例[J].激光杂志,2011,32(4):13.
    [39]杨桂华,袁道勤,王勇等.声带粘膜下吸切术并注射疗法治疗声带息肉及小结[J]. Journal of Audiology and Speech Pathology,2002,10 (4):282.
    [40]白全桂.声带周围注药和嗓音矫治治疗声带息肉62例报告[J].四川医学杂志,1998,19(2): 148-149.
    [41]赵艳梅.声带注射地塞米松治疗声带小结及声带息肉[J].中国耳鼻咽喉颅底外科杂志,2001,7(3):161.
    [42]陈舜腾.山莨菪碱治疗声带息肉样变的观察[J]. Guangdong Medical Journal, 2003,24 (6):600.
    [43]卢美琼,汪雅清.咽音法治疗声带小结和声带息肉样变[J].听力学及言语疾病杂志,1997,5(2):105,108.
    [44]梅祥胜.科学发声矫治法治疗嗓音疾病的临床研究[J].医药论坛杂志,2008,29,(3):43-44.
    [45]张三山.活血化瘀法治疗声带息肉24例[J].浙江中西医结合杂志,2002,12(11):711-712.
    [46]胡顺临,林华,陈瑜萍.复方丹参注射液超声雾化吸人治疗声带息肉的疗效观察[J].中医杂志,1997,38(11):681-682.
    [47]段雨暐.喉疳散配针刺嗓音训练治疗声带息肉56例[J].陕西中医,2008,29(6):693-694.
    [48]彭正顺,刘少英.耳穴压珠治疗声带息肉300例临床观察[J].江西医学院学报,2000,40(1):24,39.
    [49]李静波,柴峰,蔡纪堂.会厌逐瘢汤配合纤维喉镜手术治疗教师声带息肉、声带小结148例[J].四川中医,2005,23(1):83-84.
    [50]王蓉.治疗声带术后声嘶效果观察的研究[J].护理学杂志2004,19(18):5.
    [51]柳丽莉,许建英,吴世满等.布地奈德,特布他林溶液联合吸入对哮喘呼之液速改善的观察[J].中国实用内科杂志,2001,21(3):166-167.
    [52]邓嘉虹,姜鹤群,张林等.吸入用布地奈德混悬液对声带息肉术后的疗效观察[J].云南医药,2009,30(6):673-675.
    [53]杨烨,高下,陈峰等.术前使用布地奈德对声带息肉手术疗效的影响的研究[J].山东大学耳鼻喉眼学报,2009,23(4):58-62.
    [54]宁金梅,吴平.糖皮质激素在治疗声带息肉中的应用的综述[J].云南医药,2009,30(2):264-271.
    [55]孙慧娟,陈鸣等.普米克令舒雾化吸入在声带息肉手术后的疗效分析的研究[J]. J Clin Otorhinolaryngol Head Neck Surg(China),2009,23(20):951-952.
    [56]赵春霞,郭明坤,管芳等.声带息肉患者术后布地奈德混悬液雾化吸人疗效观察[J].中国医学工程,2010,18(1):155-157.
    [57]薛明,房江滨,宋学章.普米克在声带息肉术后的应用[J].中国中西医结合耳鼻喉科杂志,2002,1(6):285-286.
    [58]张爱兵,陈海蒂等.声带息肉、声带小结术后患者普米克令舒与沐舒坦联合应用疗效观察[J].TODAY NURSE,2010,7 (7):88-89.
    [59]罗贤娥,段卫红,万世恒等.报道声带息肉术后结合半导体激光治疗的疗效分析[J].现代中西医结合杂志,2006,15(15):2036-2037.
    [60]王正,杨小华等.中西医结合治疗声带息肉86例[J].江西中医药,2009,40(323):57.
    [61]陈宇,唐月英,张国庆,曾屹生,许亚桦等.声带息肉术后中西医结合治疗研究[J].光明中医,2011,26(10):2038-2039.
    [62]吴志学,郭伟,陈玉等.中西医结合治疗声带息肉术后喉嗓音80例[J].陕西中医2003,24 (9):796-797.
    [63]柯为洵.自拟开音散结汤对声带息肉摘除术后康复的疗效观察[J].吉林大学学报(医学版),2009,,3(6):1102.
    [64]田理,贾德蓉,何群明等.活血养阴法在声带息肉摘除术后的临床运用[J]. Chin J Otolaryngol Integrat Trad & West Medi 2005,13 (5):268-269.
    [65]洪钱江,朱祥成等.爽声糖浆用于声带息肉术后疗效观察[J].中国中西医结合耳乒胭喉科杂志,1994,2(2):85.
    [66]陆明芳.中西医结合治疗声带息肉及嗓音音声疗效分析[J].浙江中西医结合杂志,1997,7(5):263-264.
    [67]刘春华.中西医结合治疗声带息肉的临床体会临床研究[J]. Journal ofClinicaland ExperimentalMedicine,2009,8 (5):88-89.
    [68]张新玲,於荣铸,陶春平等.通窍活血汤联合手术治疗声带息肉临床研究[J].中医学报,2011,26(163):1427-1428.
    [69]李静波,柴峰,蔡纪堂等.会厌逐瘀汤配合纤维喉镜手术治疗教师声带息肉、声带小结[J].四川中医,2005,23(1):83-84.
    [70]吴家骏,方争胜.中西医结合治疗对声带息肉术后嗓音康复的疗效观察[J].耳鼻咽喉辩杂志,1996,4(2):94.
    [71]马胜民,刘福官,李苏玲等.开音痰瘀消方治疗声带息肉术后38例临床研究[J].江苏中医药,2011,43(1):26.
    [72]樊治军,徐庆文.补中益气汤治疗声带息肉术后疗效观察[J].中医中药·中西医结合,2010,3(7):188.
    [73]侯庆军,蔡继云,梁振等.清开灵雾化吸入对声带息肉术后恢复的影响的研究[J].中国综合临床,2006,22(8):763.
    [74]蒋湘莹.新癀片治疗声带息肉摘除术后反应50例[J].中国耳鼻咽喉颅底外科杂志,2006,12:22.
    [75]陈玉赞,陆庆春,史书垣等.西瓜霜喷雾剂在声带息肉术后应用的疗效观察研究[J].中国中西医结合耳鼻咽喉科杂志,1998,6(3):143.
    [76]李洁,黄晓敏,林杰等.对黄氏响声丸治疗声带息肉疗效观察[J].现代中西医结合杂志,2002,19(10):1872-1873.
    [77]陈文勇,陈彩凤,李云英等.金喉系列药物对声带息肉支撑喉镜术后的疗效观察[J].上海中医药杂志,2008,42(11):53-54.
    [78]刘巨波,刘亚丽,冯志坚等.金嗓散结丸对声带息肉和小结激光术后疗效的研究[J].中国眼耳鼻喉科杂志,2007,7(1):33-34.
    [79]黄炜.支撑喉镜下手术联合金嗓散结丸治疗声带息肉及声带小结326例疗效分析[J].中国医药导报,2010,7(25):141.
    [80]张惠琴,林尚泽等.对金嗓散结丸和金嗓开音丸对声带息肉及声带小结的疗效观察[J]. J Clin Otorhinolaryngol (China),2005,19 (8):363-364.
    [81]张树胜,郭小红等.金嗓散结丸加金嗓清音丸在声带息肉、小结术后的临床疗效观察[J].中国民康医学,2011,23(1):21-23.
    [82]孙建华,张瑜,严道南等.针刺“盛氏咽四穴”对声带息肉术后声带功能恢复的影响[J].中 国针灸,2010,30(10):822-825.
    [83]罗红强,谢强,陈丹等.谢强中医围手术期平衡康复疗法结合电子喉镜手术治疗声带息肉60例疗效观察[J].实用中西医结合临床,2011,11(6):4-5.
    [84]王启,陶波.针药加微波治疗声带息肉及小结76例临床研究[J].Chin J Otolaryngol Integrat Trad & West Medi,2005,13 (3):152-154.
    [85]肖永涛,郑钦,周静,黄昭鸣,喉部按摩法疗功能性嗓音障碍的临床研究[J].中国听力语言康复科学杂志,2009,3(30):41-43.
    [86]邓时贵,欧润妹,李云英等.雾化吸入活血化痰中药对实验动物气管分泌和微循环的影响[J].广州中医药大学学报,1999,16(6),311-313.
    [87]陈文勇,邓时贵,李云英.金喉雾化剂治疗声带小结的临床药理学研究[J].齐齐哈尔医学院学报,2006,27(13),1555-1556.
    [88]李云英,陈海,邓时贵等.金喉雾化剂治疗慢性喉炎的疗效评价及计算机声图谱分析[J].中国中西医结合耳鼻喉科杂志,1999,7(3):115-117.
    [89]陈文勇,李云英.金喉雾化剂治疗声带小结的临床研究[J].中国中西医结合耳鼻咽喉科杂志,2004,12(5),271-273.
    [90]Kasuya H, Ogawa S, Kikuchi Y. An acoustic analysis of pathological voice and its application to the evaluation of laryngeal pathology[J]. Speech Communication,1986, 2(2):171.
    [91]Rosen CA, Lee AS, Osborne J, et al. Development and vaildation of the voice handicap index-10[J]. Laryngoscope,2004,114:1 549.

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