氟哌噻吨美利曲辛联合质子泵抑制剂对伴焦虑抑郁的非糜烂性胃食管反流病的临床效果观察

目的探讨氟哌噻吨美利曲辛联合质子泵抑制剂(PPI)对伴焦虑抑郁的非糜烂性胃食管反流病(NERD)的疗效。方法采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)对2011年1月-2013年6月新疆医科大学第五附属医院收治的265例NERD患者进行心理测评,随机抽取80例伴焦虑抑郁的NERD患者分为A组和B组,每组40例,40例不伴焦虑抑郁的NERD患者为C组。A组予氟哌噻吨美利曲辛联合埃索美拉唑镁治疗,B组、C组只给予埃索美拉唑镁治疗,对比治疗前后反流性疾病诊断问卷(RDQ)、匹兹堡睡眠质量指数(PSQI)量表,以及HAMA、HAMD的评分。结果 RDQ问卷症状程度、频度总分、HAMA、HAMD、PSQI评分治疗前后差值三组间比较差异有统计学意义(F=46.93、42.64、37.36、39.73、21.35,P均0.05);A组治疗前后RDQ症状程度、频度总分的差值(分别为12.31±3.54、14.11±2.46)大于B组(5.62±3.45、5.30±2.13)(Post-hoc检验,P=0.032、0.025);A组治疗前后HAMA、HAMD、PSQI评分的差值(分别为10.23±4.31、10.22±3.32、7.10±4.02)均大于B组(分别为4.90±4.38、3.56±5.26、2.76±4.21)和C组(3.10±1.27、1.91±1.32、3.09±1.38)(Post-hoc分析,A组与B组比较,P=0.003、0.002、0.003;A组与C组比较,P=0.002、0.001、0.004)。结论氟哌噻吨美利曲辛联合PPI在治疗NERD躯体症状的同时,能显著改善伴焦虑抑郁的NERD患者的精神症状,其疗效优于单用PPI。

Effects of proton pumpinhibitor combined with flupenthixol melitracen in treatment of non-erosive gastroesophageal reflux disease with anxiety and depression

Objective To investigate the efficacy of proton pumpinhibitors （PPI） combined with flupethixol melitracen in the treatment of non-erosive gastroesophageal reflux disease （NERD） with anxiety and depression.Methods 265 NERD patients in the Fifth Affiliated Hospital of Xinjiang Medical University from Jan.2011 to Jun.2013 were tested with Hamilton Depression （HAMD）,Hamilton Anxiety （HAMA）,80 NERD patients with anxiety and depression were evenly divided into A group and B group,40 patients who were randomly selected from the NERD patients without anxiety and depression were as C group.Both flupethixol melitracen and PPI esomeprazole magnesium were administrated in A group.Only esomeprazole magnesium was given in B group and C group.Before and after the treatment,the symptoms of patients were scored according to Reflux Disease Diagnostic Questionnaire （RDQ）,Pittsburgh Sleep Quality Index （PSQI）,and HAMA,HAMD.Results The differences of different scores before and after treatment of three groups were statistically significant in RDQ frequency integrals,RDQ degree integrals,score of HAMA,score of HAMD and PSQI （F =46.93,42.64,37.36,39.73,21.35,P ＜ 0.05） ; the differences of the scores before and after treatment of A group in RDQ frequency integrals,RDQ degree integrals （12.31 ± 3.54,14.11 ± 2.46） were all higher than those of B group （5.62 ± 3.45,5.30 ± 2.13） （Post-hoc analysis,P =0.032,0.025） ; the differences of the scores before and after treatment of A group in scores of HAMA,HAMD and PSQI （10.23 ±4.31,10.22 ±3.32,7.10 ±4.02） were all higher than those of B group （4.90 ±4.38,3.56 ±5.26,2.76 ±4.21） and C group （3.10 ± 1.27,1.91 ± 1.32,3.09 ± 1.38） （Post-hoc analysis,A group vs B group：Post-hoc analysis,P =0.003,0.002,0.003 ; A group vs C group：Post-hoc analysis,P =0.002,0.001,0.004）.Conclusion For NERD patients with anxiety and depression,anti-depression drug flupenthixol melitracen can be used and the effect is superior to PPI alone.