伴过敏性咽喉炎的咽鼓管闭塞患者的综合治疗

Investigation into the comprehensive treatment of patients suffering from Eustachian tube occlusion with allergic pharyngitis

目的探讨对伴有过敏性咽喉炎的咽鼓管闭塞患者综合治疗的有效性。方法选取2015年1月至2017年12月于解放军联勤保障部队第九八八医院治疗的60例(80侧)伴有过敏性咽喉炎的咽鼓管闭塞患者纳入本研究,取得患者知情同意并经医院伦理委员会批准,按照随机数字表对照法分为两组。对照组28例(20例单侧,8例双侧)单纯行咽鼓管球囊扩张术;治疗组32例(20例单侧,12例双侧)术前30 d口服中药方剂治疗过敏性咽喉炎+咽鼓管球囊扩张术+术后30 d口服中药方剂治疗过敏性咽喉炎。对照组和治疗组其他基础治疗相同(术前口服孟鲁司特钠治疗片等)。比较两组疗效情况。计数资料比较采用χ~2检验;两组均数比较采用t检验。结果2年后随访,过敏性咽喉炎症状改善情况:治疗组治愈16例(50.00%),显效10例(31.25%),有效4例(12.50%),无效2例(6.25%),总有效率为93.75%;对照组治愈4例(14.29%),显效5例(17.86%),有效7例(25.00%),无效12例(42.86%),总有效率为57.14%;治疗组总有效率为93.75%,显著高于对照组的57.14%(P<0.05)。治疗组术后咽鼓管咽口肿胀恢复情况、术后耳闷胀感恢复情况、术后听力恢复情况显著优于对照组(P<0.05)。治疗组术后不适症状消退时间及听力恢复时间明显短于对照组(P<0.05)。结论咽鼓管球囊扩张术联合中药方剂治疗伴过敏性咽喉炎的咽鼓管闭塞,效果好、复发率低,值得临床推广应用。

Objective To investigate the efficacy of comprehensive treatment of patients suffering from Eustachian tube occlusion with allergic pharyngitis.Methods A total of 60 patients(80 sides)suffering from Eustachian tube occlusion with allergic pharyngitis admitted to 988 Hospital of Joint Service Support Force of the Chinese People’s Liberation Army from January 2015 to December 2017 were selected and included in this study.Informed consent of the patients was obtained.After approval by the Ethics Committee of the hospital,the patients were divided into two groups according to the random number table comparison method.The patients in the control group(n=28)(20 cases of one side and 8 cases of both sides)underwent simple Eustachian tube balloon dilation;the patients in the treatment group(n=32)(20 cases of one side and 12 cases of both sides)orally took traditional Chinese medicine prescriptions for the treatment of allergic pharyngitis within 30 days before operation,underwent simple Eustachian tube balloon dilation,and orally took traditional Chinese medicine prescriptions for the treatment of allergic pharyngitis within 30 days after operation.Other basic treatments in the control group and the treatment group were the same(preoperative oral administration of montelukast sodium treatment tablets,etc.).The efficacy of the two groups were compared.Count data were compared withχ~2 test,and the means in the two groups were tested with t test.Results After 2 years of follow-up,the symptoms of allergic pharyngitis were improved.In the treatment group,16 cases(50.00%)were cured,10 cases were markedly effective(31.25%),4 cases were effective(12.50%),2 cases were ineffective(6.25%),and the total effective rate was 93.75%.In the control group,4 cases were cured(14.29%),5 cases were markedly effective(17.86%),7 cases were effective(25.00%),12 cases were ineffective(42.86%),and the total effective rate was 57.14%.The total effective rate in the treatment group(93.75%)was significantly higher than that in the control group(57.14%),P<0.05.The postoperative recovery of Eustachian tube swelling and ear fullness and postoperative hearing recovery in the treatment group were significantly better than those in the control group(P<0.05).The time to the subsidence of postoperative discomfort symptoms and the hearing recovery time in the treatment group were significantly shorter than those in the control group(P<0.05).Conclusion Eustachian tube balloon dilatation combined with traditional Chinese medicine prescriptions has a good effect and low recurrence rate in the treatment of Eustachian tube occlusion with allergic pharyngitis,and is worthy of clinical promotion and application.