顽固性咽异感症病因学与伴随症状的相关性研究

目的研究咽异感症病因与伴随症状的关系,为临床初步诊断其病因提供依据。方法315例咽异感症患者仔细询问病史、系统检查,包括胃镜检查、胃食管24 h PH值测定、男性生物有效性睾酮(bioavailable tes-tostone,Bio-T)的检查、直立试验以及男子更年期综合征10个问题问卷调查,并对伴随症状、咽异感部位进行分析总结,明确病因后进行个体化治疗。结果315例患者中,茎突综合征11例、颈椎疾病7例、变态反应性咽炎5例、鼻后滴漏综合征(PNDs)21例、阻塞性睡眠呼吸暂停低通气综合症(OSHAS)7例、精神创伤29例、恐癌16例、抑郁焦虑83例、更年期综合征42例、自主神经功能紊乱11例、甲状腺疾病3例、胃食管反流27例、喉咽反流53例。其中133例部位恒定,182例部位游走不定;192例伴失眠多梦,62例伴月经紊乱,88例伴胸闷心慌,115例伴上消化道症状。结论咽异感症病因与伴随症状具有明显相关性,有时临床上可依据咽异感症的部位及伴随症状对病因进行初步诊断。

Clinical manifestations and etiology of pharyngeal paraesthesia

Objective To study the relationship between the etiology and concomitant symptoms of pharyngeal paresthesia.Methods For 315 cases suffering from pharyngeal paraesthesia,their histories were enquired,systemic examinations including gastroscopy,24 hours PH value determination of esophagus,bioavailable testosterone detection,erection experiment,and questionnaire about man climacteric syndrome were given.Their concomitant symptoms and positions of pharyngeal paresthesia were also studied.After the diagnoses were confirmed,sequence therapy and individualized combined treatment were administered.Results The etiologies of pharyngeal paraesthesia were confirmed in all cases,including styloid process syndrome(11 cases),cervical vertebrae disease(7 cases),allergic pharyngitis(5 cases),postnasal drop syndrome(21 cases),obstructive sleep apnea-hypopnea syndrome(7 cases),psychic disorders(128 cases),climacteric syndrome and menstrual disorder(42 cases),functional disturbance of parasympathetic nerve system(11 cases),thyroid diseases(3 cases),reflux esophagitis(27 cases),and laryngopharyngeal reflux(53 cases).As for the positions of pharyngeal paresthesia,133 cases were constant and 182 were changeable.Of all the cases,192 were accompanied with insomnia,62 with menstrual disorder,88 with chest flusteration,and 115 cases with digestive diseases.Conclusion The etiologies of pharyngeal paresthesia are closely related to their concomitant symptoms.Therefore,primary etiological diagnoses can be established based on the concomitant symptoms and the positions of pharyngeal paresthesia.