氟哌噻吨美利曲辛片联合B族维生素辅助治疗伴心理障碍的非糜烂性反流病临床疗效

目的观察氟哌噻吨美利曲辛片联合B族维生素辅助治疗伴心理障碍的非糜烂性反流病(NERD)的临床疗效。方法 96例NERD伴心理障碍患者按就诊顺序随机分三组,A组30例,埃索美拉唑;B组32例,埃索美拉唑加维生素B1、维生素B6;C组34例,在B组基础上加用氟哌噻吨美利曲辛片,治疗8周,观察治疗前后患者的临床症状积分变化情况;采用耐信量表诊断NERD,Hamilton抑郁量表进行NERD患者的心理障碍评估。结果 (1)反酸、烧心、胸痛积分:与治疗前比较,A、B、C三组治疗后反酸、烧心、胸痛积分下降(P<0.05);治疗后胸痛积分下降B组、C组均优于A组(P<0.05);治疗后烧心积分下降B组、C组均优于A组(P<0.01)。(2)Hamilton抑郁量表积分:治疗后C组积分明显下降,C组与A、B组比较差异显著(P<0.01)。(3)治疗有效率:A、B、C三组有效率分别是60%,81.25%及97.1%;三组间比较差异有统计学意义(χ2=13.82,P<0.01),A组与C组比较也差异有统计意义(P<0.01)。结论小剂量氟哌噻吨美利曲辛片联合B族维生素对伴心理障碍的非糜烂性反流病有辅助治疗效果,维生素B1和维生素B6可缓解患者胸痛和烧心症状。

Efficacy of auxiliary therapy of Deanxit combined with B vitamins in patients with non - erosive reflux disease accompany psychological disorder

Objective To evaluate the clinical efficacy of Deanxit combined with B vitamins as auxiliary treatment for non-erosive refulx disease（NERD） accompanied by psychological disorder.Methods Patients of NERD with psychological disorder were randomly assigned to three groups.Patients in group A（n = 30） were administered esomeprazole 20 mg once daily and patients in group B（n = 32） were administered esomeprazole 20 mg once daily combined with vitamine B1 10 mg and vitamine B6 10 mg three times daily respectively,while patients in group C（n = 34） were administered another Deanxit 1tab daily on the basis of group B.All the groups were treated for eight weeks and symptom integrals were recorded before and after the treatment.NERD was diagnosed with esomeprazole scale and psychological disorder was assessed by scores of Hamilton Depression Scale.Results（1） Integrals： Integrals of acid reflux,heartburn and chest pain decreased among A、B and C groups after treatment,and significance was obtained as compared with the corresponding integrals before treatment（P 0.05）.Decreasing of integrals of chest pain in both group B and C was superior to group A（P 0.05）,and decreasing of integrals of heartburn in both group B and C was superior to group A（P 0.01）.（2） Scores of Hamilton Depression Scale： The scores in group C decreased significantly after treatment and significance was obtained as compared with the scores in both group A and B respectively（P 0.01）.（3） Effective rate： The effective rate of group A、B and C was 60%,81.25% and 97.1% respectively.Significant difference was obtained among group A、B and C（χ 2 = 13.821,P 0.01）,as well as that between group A and C（P 0.001）.Conclusion Small amount Deanxit combined with B vitamins may be a better medication in auxiliary treatment for patients with NERD accompanied psychological disorder and vitamine B1 and vitamine B6 may alleviate symptoms of chest pain and heartburn.