胃食管反流病相关性呼吸系病及咽喉病研究

近年来发现与胃食管反流病相关的消化道外症状日益增多,国内文献对胃食管反流病的中医辨证分型中,多有报道痰气交阻或痰气郁结胸膈的类型,表明胃食管反流病,常伴有呼吸病及咽喉病症状,由于相当数量的胃食管反流病患者,其临床胃食管反流表现不明显,没有典型的烧心、反酸等反流症状,且胃食管反流病有食管黏膜上皮结构改变（反流性食管炎、Barrette上皮化生）者为34%,常易漏诊胃食管反流病,影响及时诊断与正确治疗。中医对哮喘、咳嗽、咽喉痛的治疗,经验丰富,疗效颇佳,对这类患者,尤其是常规治疗疗效不明显的,一定要考虑同时存在胃食管反流病的可能,选用抑酸剂及促动力药治疗胃食管反流病,同时加用对哮喘、咳嗽、咽喉痛有效的中西药,以提高疗效。本文介绍胃食管反流病相关性呼吸系病及咽喉病的现状及中医对它们的认识,旨在提高对这类疾病的认识,及时诊断和治疗不典型的胃食管反流病,避免漏诊或误诊。

Study of gastroesophageal reflux disease(GERD) related respiratory diseases and diseases of pharynx-larynx

In recent years,the studies show extraesophageal symptoms are increasingly appeared in GERD patients.Those with symptom complex of phlegm and qi are commonly founded when differentiated by traditional Chinese medicine method.The studies show that GERD often accompanied by respiratory disease and throat disease symptoms,for a significant number of GERD patients,whose clinical manifestations of gastroesophageal reflux are not obvious,no typical heartburn,acid reflux,and esophageal structure change（reflux esophagiteis,Barrentt metaplasia） is 34% in the GERD,often GERD is missed,diagnosis and treatment are affected.Traditional Chinese medicine in the treatment of asthma,cough,sore throat has experience and good effect,but for these patients,the effect is not good,and perhaps concluding the GERD,traditional Chinese medicine and west medicine should be included in order to improve the effect.This paper introduces the GERD related diseases of respiratory system and throat disease status and traditional Chinese medicine understanding,in order to enhance the understanding of the diseases,timely diagnosis and treatment of atypical GERD and avoid missed diagnosis or misdiagnosis.