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J Korean Soc Laryngol Phoniatr Logop > Volume 18(2); 2007 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2007;18(2): 108-112.
인후두역류의 약물치료
주형로
한림대학교 의과대학 이비인후-두경부외과학교실
Medical Treatment of Laryngopharyngeal Reflux
Hyung-Ro Chu
Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine
ABSTRACT
Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms ; and the constellation of symptoms has been called laryngopharyngeal reflux (LPR). In the absence of definite diagnostic criteria, LPR disease remains a subjective entity. A diagnosis of LPR is usually based on response of symptoms to empirical treatment. Investigative modalities such as pH monitoring and, more recently, impedance studies are generally reserved for treatment failures. LPR usually requires more aggressive and prolonged treatment to achieve regression of both symptoms and laryngeal findings. The suppression of gastric acid and secretion with anti-secretary agents has been the mainstay of medical treatment for patients with acid-related disorders. The suppression of gastric acid secretion achieved with Hz-receptor antagonist $(H_2RA)$ has proved suboptimal for relief of reflux symptoms. The rapid development of tolerance and rebound acid hypersecretion after the with-drawal of $H_2RA$ limit their clinical use. Proton pump inhibitors (PPI) have been proved to be very effective for suppressing intragastric acidity, but the optimal dose and duration is unknown. Current evidence indicates that pharmacologic intervention should include, at a minimum, a 3 month trial of twice daily PPI. Symptoms of LPR improve over 2 months of therapy. The physical findings of LPR resolve more slowly than the symptoms and this continues through out at least 6 months of treatment. For most patients with LPR, twice daily dosing with a PPI is usually recommended for an initial treatment for a period of no less than 6 months treatment, and lifetime treatment may be required.
KEY WORDS: Laryngopharyngeal reflux;$H_2-receptor$ antagonist;Proton pump inhibitor;
중심 단어: 인후두역류;$H_2$수용체 차단제;양성자 펌프 억제제;
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