论文部分内容阅读
背景:咽部的微循环障碍可能是促使慢性咽炎反复发作的一个发病学基础,而负压治疗能通过生物力学的变化,改善炎症靶器官的微循环。目的:观察口腔负压对慢性咽炎患者的症状和甲襞微循环的改善效果。设计:随机单盲对照观察。单位:河北北方学院病理生理教研室。对象:2002-01/09河北北方学院附属第一医院耳鼻咽喉科收治慢性咽炎患者65例;病程1～3年。随机分为治疗组(n=35)和对照组(n=30)。其中,慢性单纯性咽炎36例(治疗组18例,对照组18例),慢性肥厚性咽炎29例(治疗组17例,对照组12例)。方法:应用Hices口腔负压仪,将负压施加器放入口腔的最适位置,调节负压维持在(0.05±0.01)MPa。治疗时间10min/次(首次5min),1次/d,时间固定,5d为1个疗程,共3个疗程。对照组同样口含负压施加器10min/次,但不给负压。主要观察指标:①甲襞微循环观察与评价:应用XTL-Ⅱ型微循环显微电视系统进行甲襞微循环观察,常规检查左手无名指甲襞第一排管袢,记录微血管形态、微血流状态和袢周状态,按田牛等加权积分法对微循环障碍程度进行定量分析,积分值低说明微循环状态良好。②治疗3个疗程后的咽炎症状改善情况。结果:65例均进入结果分析。①治疗组负压治疗1个疗程后,1/3患者症状显著改善;3个疗程结束后,除咽后壁淋巴滤泡增生及咽侧索增厚等增生性形态学变化未见显著改善外,症状及咽部黏膜充血体征的出现率均显著低于治疗前及对照组(P<0.05～0.01)总有效率为89%。②负压使治疗组慢性咽炎患者微循环障碍明显改善,由治疗前的中度异常恢复到大致正常,总积分值由4.836±0.242降低至1.941±0.165(P<0.01)。结论:口腔负压能明显缓解或消除慢性咽炎的症状和体征,其机制可能与改善微循环障碍有关。
Background: The pharyngeal microcirculation disorder may be the basis of the pathogenesis of repeated episodes of chronic pharyngitis, and negative pressure therapy can improve the microcirculation of target organs through the change of biomechanics. Objective: To observe the effects of oral negative pressure on the symptoms of patients with chronic pharyngitis and microcirculation of formazan. Design: Randomized single-blind control observation. Unit: Hebei North University Department of Pathophysiology. PARTICIPANTS: A total of 65 patients with chronic pharyngitis were admitted to otolaryngology department of the First Affiliated Hospital of Hebei North University from January to September in 2002. The course of disease ranged from 1 to 3 years. Randomly divided into treatment group (n = 35) and control group (n = 30). Among them, 36 cases of chronic simple pharyngitis (treatment group 18 cases, control group 18 cases), chronic hypertrophic pharyngitis 29 cases (treatment group 17 cases, control group 12 cases). Methods: Using Hices oral negative pressure meter, the negative pressure applicator was placed in the optimum position of oral cavity, and the negative pressure was maintained at (0.05 ± 0.01) MPa. Treatment time 10min / time (the first 5min), 1 time / d, time fixed, 5d for a course of treatment, a total of 3 courses. The same control mouth oral negative pressure applicator 10min / time, but not to negative pressure. MAIN OUTCOME MEASURES: ①Nailfold microcirculation observation and evaluation: Using XTL-Ⅱmicro-microcirculation microsurgical system to observe the microcirculation of nailfolds, the first row of tubes of the left-handed nailfinger was checked routinely, and the microvessel morphology, micro-blood flow State and Zhou Zhou state, according to Tian Niu and other weighted integral method to quantitatively analyze the degree of microcirculation, low integral value shows that the microcirculation state is good. ② treatment of 3 courses of pharyngitis symptoms improved. Results: 65 cases were involved in the result analysis. ① After treatment with negative pressure in treatment group, one-third of patients showed significant improvement in symptoms; after three courses of treatment, no significant improvement was found in the hyperplastic morphological changes except lymphoid follicular hyperplasia and thickening of pharyngeal lateral cord , The symptoms and signs of pharyngeal mucosal congestion were significantly lower than before treatment and control group (P <0.05 ~ 0.01), the total effective rate was 89%. (2) Negative pressure significantly improved the microcirculation disturbance in patients with chronic pharyngitis, from normal before treatment to normal, with the total score decreased from 4.836 ± 0.242 to 1.941 ± 0.165 (P <0.01). Conclusion: Oral negative pressure can obviously relieve or eliminate the symptoms and signs of chronic pharyngitis. The mechanism may be related to the improvement of microcirculation.