慢性非特异性咽炎:发病机制和治疗问题(问卷调查数据和文献综述)

M. Shakhova, V. A. Fokeev, V. Svistushkin, A. V. Shakhov
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摘要

慢性非特异性咽炎(CNP)是一种极为常见的病症,但目前尚无规范CNP诊断和治疗的共识文件。我们编制了一份关于慢性非特异性咽炎问题的调查问卷,在从业人员中分发了谷歌表格,并进行了调查和答案分析。随后,我们在 PubMed、eLibrary.Ru、CyberLeninka 等平台以及其他开放式互联网资源上对有关该主题的科学著作进行了搜索和分析。专家调查数据与文献综述结果进行了比较。CNF 的治疗和诊断方法在很大程度上取决于医疗机构的传统生活方式。这一事实,以及缺乏有关 CNF 问题的规范性文件,使得很难对该疾病进行有效诊断并选择适当的治疗策略。研究结果表明,CF 应被视为一种多因素疾病,并关注患者的合并症。绝大多数受访者认为胃食管反流和其他肠胃疾病是主要的致病因素。这一点在文献中得到了证实,而我们采访的专家也建议,应主要偏重于对主诉、病史和咽喉镜检查的评估。仅使用外用药物治疗 CNF 的处方随处可见,但并不能达到预期效果。有必要在耳鼻喉科医生和其他专业医生(消化科医生、内分泌科医生、精神科医生和神经科医生)的参与下,进行多阶段治疗,以消除致病因素,纠正局部病变。
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Chronic nonspecific pharyngitis: еtiopathogenesis and treatment Issues (questionnaire data and literature review)
Chronic nonspecific pharyngitis (CNP) is an extremely common pathology, but there are no consensus documents regulating the diagnosis and treatment of CNP. We compiled a questionnaire with a list of questions on the problem of CNF, distributed a google form among practitioners and conducted a survey with subsequent analysis of the answers. Then, a search and analysis of scientific works on this topic was carried out on the platforms PubMed, eLibrary.Ru, CyberLeninka, as well as in other open Internet sources. The data of the survey of specialists are compared with the results of the literature review. Therapeutic and diagnostic approaches in CNF are largely determined by the traditional ways of life of a medical institution. This fact, as well as the lack of regulatory documents on the problem of CNF, makes it difficult to competently diagnose and choose an adequate treatment tactics for this disease. The results of the study suggest that CF should be considered as a multifactorial disease, paying attention to the comorbid profile of the patient. The vast majority of respondents consider gastroesophageal reflux and other gastroenterological diseases to be the main predisposing factors. This is confirmed by the literature, and the specialists interviewed by us suggest that the main bias should be made to the assessment of complaints, anamnesis, and pharyngoscopy. Therapy of CNF with the use of only topical drugs is prescribed everywhere, but does not give the desired result. It is necessary to have a multi-stage treatment aimed at eliminating predisposing factors and correcting local changes with the involvement of not only otorhinolaryngologists, but also doctors of other specialties (gastroenterologists, endocrinologists, psychiatrists and neurologists).
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