喉接触性肉芽肿的病因分析及非手术治疗的疗效分析

Analysis on the causative factors of laryngeal contact granuloma and the therapeutic effect of non-operative therapy on this kind of lesion

目的 探讨喉接触性肉芽肿的病因及非手术疗法的疗效.方法 喉接触性肉芽肿患者49例,回顾性分析其相关临床资料,探讨其发病因素,总结去除病因疗法结合口服中成药玄柏爽声方治疗的临床效果.结果 本组病例的相关发病因素有慢性喉炎（49例,100%）、喉咽返流（27例,55%）、用声过度（23例,占47%）、饮酒（20例,占41%）、吸烟（18例,37%）和不明原因（7例,占14.7%）等.经非手术疗法治疗后,36例（74%）肉芽组织全部消失,肉芽消失时间为3~13月,平均8.6个月.有喉咽返流的接触性喉肉芽肿患者治愈率为75%（20/27）,用声过度、吸烟和饮酒的患者,其治愈率分别为63%（14/23）、83%（15/18）、79%（16/20）,不明病因患者的治愈率为71%（5/7）.不同病因所致肉芽肿患者亚组间的疗效差异无统计学意义（P〉0.05）.结论 喉接触性肉芽肿常为多种病因所致,去除病因疗法结合口服中成药玄柏爽声方治疗可获明显疗效.

Objective To explore the causative factors of laryngeal contact granuloma and the therapeutic effect of non-operative therapy on this kind of lesion based on a clinical trial. Method Included in this study were 49 cases with laryngeal contact granuloma treated at our Hospital from Mar., 2011 to Feb., 2015, with their all clinical data analyzed in a retrospective way to explore the possibly associated causative factors and the therapeutic effect of a non-operative therapy, mainly composed of herbal preparation Shuangsheng Granules orally taken. Result The related causative factors among these 49 cases included chronic pharyngitis （49, 100%）, laryngopharyngeal reflux （27, 55%）, inappropriate vocal use （23, 47%）, alcohol consumption （20, 41%）, smoking （18, 37%） as well as those with causative factor undefined（7, 14.7%）, ranked in a declining order. Following the treatment of non-operative therapy, granuloma was completely disappeared in a majority of patients（36/49, 74%） 3 to 13 months following the non-operative therapy, with an averaged period of 8.6 months. The curative rates were 75% （20/27）, 63% （14/23）, 83% （15/18）, and 79% （16/20） for cases with the causative factors being laryngopharyngeal reflux, inappropriate vocal use, smoking, and alcohol consumption respectively. However, there was no significantly statistical significance present in the therapeutic effects among these groups with different causative factors following the same non-operative treatment （P〉0.05）. Conclusion Multiple causative factors may attributed to the development of laryngeal contact granuloma, and the non-operative therapy, mainly composed of Shuangsheng granules as reported here, should be effective for the treatment of this kind of lesion.