Discussion On The Subjective Efficacy Of Voice Training Combined With Jinsang Capsules In The Treatment Of Chronic Aphonia With Qi Stagnation And Blood Stasis

Objective By comparing scores of voice handicap index-10(VHI-10),Grade,roughness,breathiness,asthenia,strain scale(GRBAS),reflux symptom index(RSI)before and after treatment through voice training and Jinsang capsules,we analyze the relationship between the subjective scales,influence of reflux factors on Chronic aphonia,the improvement of subjective feeling of patients.To explore the therapeutic effect of voice training combined with Jinsang capsules on patients with Chronic aphonia with qi stagnation and blood stasis.Methods 26 patients diagnosed as chronic aphonia in the Otolaryngology Department of Wuhan First Hospital from October 2019 to January 2020 were selected,among them,10 patients with lung and kidney Yin deficiency were treated with Liyan pill and Qingyin pill,7 of them with lung and spleen qi deficiency were treated with Kaiyin pill,9 of them with Qi stagnation and blood stasis were treated with Sanjie pill and Kaiyin pill,the two pills were taken alternately on alternate days for 1 month.At the same time,voice training was required for 1 month under the standard guidance of a professional doctor of phonetics,with a minimum of 30 minutes per day.VHI-10,RSI was completed before and after treatment under the guidance of professional doctors,and GRBAS was assessed for the severity of the voice of the patients by 3 professional doctors of phonetics.Paired t test was performed for the total scores before and after treatment.Correlation analysis was conducted among all different scales to compare the correlations among different scales,while comparing the correlations between gender and age and subjective feelings.Paired t test was performed on patients’ self-assessment scores before and after treatment to evaluate the efficacy of voice training and Jinsang capsules.Results1.VHI-10 was strongly correlated with total RSI scores(r=0.65,p<0.01),Patients with abnormal RSI(RSI≥13)accounted for 50% of the total,and the VHI-10 scores were different from that patients of abnormal RSI with normal RSI(t=4.21,P<0.01).There was also a correlation between RSI and the physiological,functional and emotional parts of the VHI-10,with the highest correlation with the physiological part.RSI and VHI-10 were not correlated with GRBAS(p>0.05).2.There was no significant correlation between RSI and age,VHI-10 and age(r=0.02,r=-0.23,P>0.05),there were no significant differences in RSI and VHI-10 scores between different genders too(t=0.80,t=0.81,P>0.05),but there were statistical differences in GRBAS among different genders(P<0.05).3.There were statistically significant differences in VHI-10,GRBAS scores before and after treatment(P<0.05).In GRBAS,there was no statistically significant difference in the improvement of breath degree(P>0.05),while the other parts were significantly improved(P<0.05).The scores of all parts of VHI-10 scale were improved,among which physiological part was the most obvious improvement.The RSI’s difference before and after treatment was not statistically significant.Conclusion1.There was a positive correlation between VHI-10 and RSI,patients with abnormal RSI would get higher VHI-10 scores,RSI and VHI-10 self-perceived symptoms may overlap,abnormal RSI may be caused by the patients feel voice serious obstacle,rather than the effect of reflux.Therefore,it is believed that the diagnosis of laryngopharyngeal reflux disease(LPRD)can not only rely on RSI abnormality in patients with Chronic aphonia.The poor correlation between RSI and GRBAS,VHI-10 and GRBAS may be caused by the different subjects of filling the scale.2.Age and gender were not factors affecting patients’ subjective symptom scores,but GRBAS from the perspective of doctors suggested that female hoarseness may be higher,which may be related to the shorter and thinner physiological structure of female vocal cords and bad vocal habits.3.vocal training combined with Jinsang capsules can improve the subjective voice experience of patients with chronic aphonia with Qi Stagnation and Blood Stasis.However,there was no significant improvement in reflux symptoms.