黛力新联合雷贝拉唑治疗难治性消化性溃疡合并焦虑、抑郁患者48例效果观察

目的探讨黛力新（氟哌噻吨美利曲辛）联合雷贝拉唑治疗难治性消化性溃疡合并焦虑、抑郁患者的临床效果。方法运用Hamilton焦虑量表（HAMA）和Hamilton抑郁量表（HAMD）评分筛选出合并焦虑、抑郁状态的难治性消化性溃疡患者48例，随机分为A组（24例）和B组（24例），B组第1周用四联疗法（雷贝拉唑、克拉霉素片、阿莫西林胶囊、胶体果胶铋胶囊）抗幽门螺杆菌（Hp）治疗1周，然后继续服用雷贝拉唑10mg，2次／d，早、中餐前各1次，共7周；A组在B组治疗的基础上加用黛力新10．5mg，2次／d，早、中餐后各1次。疗程结束后通过症状改善情况、胃镜检查疗效、Hp清除率及治疗前后HAMA、HAMD评分改善情况判断疗效。结果经治疗8周后，两组症状缓解比较，A组疼痛消失率为95．8％，B组为41．7％；两组胃镜检查疗效比较：A组显效牢为70．8％，溃疡愈合率为91．7％，总有效率为100．0％；B组显效率为50．0％，溃疡愈合率为79．2％，总有效率为91．7％；对Hp清除率A组为95．8％，B组为79．2％。两组比较差异有统计‘学意义（P〈0．05）。与治疗前比较，两组治疗后HAMA和HAMD评分均下降，但A组差异有统计学意义（P〈0．05）；B组差异无统计学意义（P〉0．05）。结论对于难治性消化性溃疡患者应注意焦虑、抑郁等心理精神障碍的评估，对合并焦虑、抑郁状态患者行常规治疗的同时，联合黛力新改善焦虑、抑郁情结治疗，可明显改善焦虑、抑郁状态，降低内脏的高敏性，提高疗效，提高患者的生活质量

Observation on clinical efficacy of Deanxit in combination with Rabeprazole for 48 patients with refractory peptic ulcer combined with anxiety and depression

Objective To study the clinical efficacy of Deanxit （Flupentixol and Melitracen） in combination with Rabeprazole in treating patients with refractory peptic ulcer combined with anxiety and depression. Methods 48 patients with refractory peptic ulcer combined with anxiety and depression, evaluated with Hamiiton rating scale for depression （HAMD） and Hamilton anxiety scale （HAMA）, were randomly assigned into two groups： group A （n = 24） and group B （n = 24）. Group B was treated with quadruple therap （Rabeprazole, Clarithromycin, Amoxil Capsule, Colloidal Bismuth Pectin Capsules） to clear of Hp in first week, then taking Rabeprazole （10 mg） bid before breakfast and lunch respectively. The period for the treatment was seven weeks. Group A in the conventional treatment was added Deanxit （10.5 mg） bid after breakfast and lunch respectively. After treatment for 8 weeks, two groups were compared in terms of improvement of clinical symptoms, gastroscopy effects, Hp clearance rate, and differences of HAMD, HAMA scores. Results At 8 weeks treatment, there were significant differences between the two groups on symptoms of the pain relief rate （95.8% in group A vs 41.7% in group B）, on Gastroscopy effects （in excellence rate 70.8% in group A vs 50.0% in group B; ulcer healing rate 91.7% in group A vs 79.2% in group B and total effective rate 100.0% in group A vs 91.7% in group B） （P 〈 0.05）; on Hp clearance rate （95.8% in group A vs 79.2% in group B） （P 〈 0.05）; after treat- ment HAMA and HAMD scores of the two groups decreased, there were significant differences in group A （P 〈 0.05）, while there were no significant differences in group B （P 〉 0.05）. Conclusion In patients with refractory peptic ulcer, it is necessary to evaluate the levels of anxiety and depression. Combining the conventional treatment and application of Deanxit, it is a remarkable effective method for treating refractory peptic ulcer combined with anxiety and depression in patients, which can reduce the visceral hyperreactivity, improve curative effect, and improve the patient＇s quality of life.