Evaluate The Efficacy Of Drug Therapy Combined With Voice Therapy In The Management Of Vocal Nodules

Objective:To compare the efficacy of single drug therapy、single voice therapy and drug therapy combined with voice therapy in subjective and objective aspects, in order to guide clinical treatment.Methods:69female patients with vocal nodes were randomly divided into three groups:A、B、 C,each group has23cases.50healthy female adults were as a normal control group, notes for D. Group A was treated by single drug therapy, Group B was drug therapy combined with voice therapy, Group C was single voice therapy. The treatment lasted4weeks. The results were evaluated by voice handicap index、voice acoustic analysis、laryngostroboscope. The SPSS18.0software package was used for statistical analysis, measurement date was shown as x±s the comparison was with t test, and count date was analysed by χ2, P<0.05was considered statistically signigicant.Results:1.Before treatment patients with vocal nodules VHIT, F, P, E corresponding score were significantly higher than that of normal control group (P<0.01). Patients in Group A after treatment with drugs VHI T, F, P, E score compared with before treatment were obviously reduced (P<0.01). However, compared with normal control group, except P no significant statistical difference, F, E, T were still higher than that of normal group(P<0.05). Group B patients after combination treatment VHI T, F, P, E score compared with before treatment were obviously reduced,(P<0.01), and compared with normal control group, F, P, E, T was close to normal (P>0.05). Patients in Group C after voice training therapy VHI T, F, P, E score compared with before treatment were obviously reduced (P<0.01), however, compared with normal control group, F, P, E, T were still significantly higher than the normal group (P<0.01). Three groups before treatment VHI rating scale had no obvious statistics difference(P>0.05), after treatment VHI scale score in Group B was lowest and have obvious difference (P<0.01).2.Vocal nodules patients before treatment compared with normal control group were lower F0, high JITTER, SHIMMER, NHR,(P<0.01). Patients in Group A after drug treatment compared with before treatment FO was higher, JITTER, SHIMMER, NHR ware lower (P<0.01), however, compared with normal control group, F0, JITTER, SHIMMER, NHR were still statistically significant (P<0.05). Patients in Group B after combined treatment compared with before treatment were with significant higher F0, and reduced JITTER, SHIMMER, NHR (P<0.01), although FO, NHR value compared with the normal control group, there was still a statistical difference (P<0.05), but JITTER, SHIMMER were already basic close to normal and no obvious statistical significance difference (P>0.05). FO and NHR of patients in Group C after voice training compared with before treatment were not found changes (P>0.05), JITTER, SHIMMER value falled (P<0.05), but compared with the normal control group, F0, JITTER, SHIMMER, NHR ware still statistically significant (P<0.01). Voice acoustic parameters of three groups before treatment had no obvious statistics difference,(P>0.05), after treatment besides NHR had no difference between Group A and B, F0in Group B was significantly higher than Group A and C (P<0.01), JITTER, SHIMMER in Group B were significantly lower than that in Group A and C(P<0.01), NHR in Group B was lower than that in Group C(P<0.05).3. According to laryngostroboscope, after treatment, the total effective in Group A, was82.6%; in Group B was95.7%; in Group C was60.9%. The total effective rate of treatment in Group B was highest (P<0.01).Conclusion:Single drug therapy, single voice therapy and drug therapy combined with voice therapy all have certain curative effect in the treatment of patients with vocal nodules, but drug therapy combined with voice therapy in the treatment of vocal nodules is better, more efficiently, and can improve patients with pronunciation features,which is worth to promotion in clinical application.