Effects of proton pump inhibitors plus gastroprokinetic agents on laryngopharyngeal reflux disease and factors influencing prognosis.

OBJECTIVE: To assess the efficacy of proton pump inhibitors (PPIs) combined with gastroprokinetic agents for laryngopharyngeal reflux disease (LPRD) and to explore factors associated with prognosis. METHODS: A retrospective analysis was performed in 120 patients with LPRD treated at our institution from January 2023 to December 2024. They were classified into a combination group (n=60, PPI plus gastroprokinetic agents) and a monotherapy group (n=60, PPI alone). The two groups were compared before and after treatment in terms of the Reflux Symptom Index (RSI) score, Reflux Finding Score (RFS), 24-hour pharyngeal pH monitoring indicators, treatment efficacy, and the incidence of adverse events. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing prognosis. RESULTS: After treatment, the combination group showed significantly lower RSI and RFS scores, lower Ryan score, number of reflux episodes, and percentage of reflux time than the monotherapy group (P<0.05). A significantly higher overall response rate was observed in the combination group than in the monotherapy group (91.67% vs. 73.33%, P<0.05). Disease duration ≥12 months, concomitant hiatal hernia, body mass index (BMI) ≥28 kg/m2, and smoking history served as independent risk factors for LPRD prognosis (P<0.05). Combination therapy was a protective factor (P<0.05). CONCLUSIONS: PPIs combined with gastroprokinetic agents are more effective than PPIs alone for patients with LPRD. This combination therapy alleviates patients' symptoms and improves their signs. Disease duration, BMI, hiatal hernia, smoking history, and treatment regimen are important factors influencing prognosis. Comprehensive interventions may improve patient prognosis.