质子泵抑制剂联合氟哌噻吨美利曲辛对改善胃食管反流病合并焦虑及抑郁患者临床症状及精神状态的作用

摘要

目的 探讨质子泵抑制剂(PPI)联合氟哌噻吨美利曲辛对于改善伴有焦虑抑郁的胃食管反流病(GERD)患者临床症状及精神状态的作用.方法 选取2016年3月至2017年3月于新疆医科大学附属中医医院就诊的70例伴有焦虑抑郁的GERD患者,按就诊顺序分为对照组及观察组,每组35例.对照组服用艾司奥美拉唑治疗;观察组在对照组基础上加服氟哌噻吨美利曲辛治疗;2组均治疗8周.观察2组患者治疗前后的临床症状、焦虑、抑郁及睡眠质量评分的改善情况,并根据患者症状改善情况评定疗效.同时观察不良反应.结果 2组患者治疗后症状评分和汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)评分均较治疗前明显改善;观察组治疗后反酸、胸骨后疼痛、烧心、反食症状评分均明显低于对照组[(1.26±0.43)分比(2.32±0.41)分、(1.53±0.25)分比(2.64±0.45)分、(1.34±0.48)分比(2.31±0.53)分、(1.02 ±0.15)分比(1.86±0.47)分],HAMA、HAMD、PSQI评分均明显低于对照组[(4.8±0.6)分比(8.6±1.6)分、(5.7±0.4)分比(9.7±1.4)分、(3.26±0.59)分比(5.58±0.26)分],差异均有统计学意义(均P＜0.05).观察组总有效率明显高于对照组[88.6％ (31/35)比74.3％ (26/35)],差异有统计学意义(P =0.037).2组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 PPI联合氟哌噻吨美利曲辛可缓解伴焦虑抑郁GERD患者的躯体症状,并明显改善焦虑、抑郁等精神状态及睡眠状况,疗效优于单用PPI.%Objective To investigate the effect of proton pump inhibitor(PPI) combined with flupenthixol melitracen on physical symptoms,anxiety and depression symptoms in patients with gastroesophageal reflux disease (GERD).Methods A total of 70 patients with GERD accompanied by anxiety and depression were enrolled from March 2016 to March 2017 in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University;they were divided into observation group and control group with 35 cases in each group.The control group took esomeprazole;the observation group took flupenthixol/melitracen tablets and esomeprazole.After 8 weeks of treatment,clinical symptoms,anxiety and depression symptoms,quality of sleep and the total curative effect were analyzed.Results Scores of physical symptoms,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD) and Pittsburgh Sleep Quality Index (PSQI) were significantly improved after treatment in both groups;scores of acid regurgitation,retrosternal pain,heartburn and esophageal reflux in observation group were significantly lower than those in control group[(1.26 ± 0.43) points vs (2.32 ± 0.41) points,(l.53 ± 0.25) points vs (2.64 ± 0.45) points,(1.34 ± 0.48) points vs (2.31 ± 0.53) points,(1.02 ± 0.15) points vs (1.86 ±0.47) points] (P ＜ 0.05);scores of HAMA,HAMD and PSQI in observation group were significantly lower than those in control group [(4.8 ± 0.6) points vs (8.6 ± 1.6) points,(5.7 ± 0.4) points vs (9.7 ± 1.4) points,(3.26 ± 0.59) points vs (5.58 ± 0.26) points] (P ＜ 0.05).The total effective rate in observation group was significantly higher than that in control group [88.6％ (31/35) vs 74.3％ (26/35)] (P =0.037).The adverse reaction rate had no significant difference between groups (P ＞ 0.05).Conclusion PPI combined with flupenthixol melitracen can relieve physical symptoms of GERD,release mental symptoms of anxiety and depression and improve sleep status.