title: Efficacy of proton pump inhibitor in combination with rikkunshito in patients complaining of globus pharyngeus.
abstract: OBJECTIVE
  Globus pharyngeus (GP) is a common symptom of laryngopharyngeal reflux disease (LPRD), and proton pump inhibitor (PPI) and rikkunshito, a traditional Japanese medicine having prokinetic effect improve LPRD symptoms. In the present study, we examined the efficacy of high-dose PPI in combination with rikkunshito in patients complaining of GP.
  
  
  METHODS
  106 patients complaining of GP without any organic endoscopic findings were enrolled.
  
  
  RESULTS
  Patients were first administrated with high-dose PPI alone for 4 to 8 weeks and the symptom was improved in 65 patients. Among 41 patients with PPI-refractory GP, 22 patients were administrated with high-dose PPI in combination with rikkunshito, and the symptom was improved in 14 of 22 patients 4 weeks later. The average value of a modified reflux symptom index of the responders was similar to that of non-responders. Only a few patients had positive values in reflux finding scores in both groups.
  
  
  CONCLUSIONS
  The present findings suggest the existence of a high prevalence of LPRD in patients complaining of GP. The data also suggest that gastroesophageal dysmotility is involved in GP, in addition to excessive acid reflux. The pre-therapeutic laryngopharyngeal symptoms and endoscopic findings could not predict the efficacy of the treatment for GP. J. Med. Invest. 63: 227-229, August, 2016.
authors.affiliation: Department of Otolaryngology, Kochi National Hospital.
authors.forename: Sei-Ichi
authors.initials: S
authors.lastname: Nakano
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Eiji
authors.initials: E
authors.lastname: Kondo
authors.forename: Katsushi
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Shizuku
authors.forename: Sei-Ichiro
authors.initials: S
authors.lastname: Kamimura
authors.forename: Junya
authors.initials: J
authors.lastname: Fukuda
authors.forename: Ryo
authors.initials: R
authors.lastname: Kanamura
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*
chemical_list: D004365:Drugs, Chinese Herbal; D054328:Proton Pump Inhibitors; C084136:liu-jun-zi-tang