Objective To investigate the effect of flupentixol and melitracen tablets (deanxit) combined with gastric motor drug in treating non-erosive gastroesophageal reflux disease (NERD) complicated with depression.Methods Toally 97 NERD patients complicated with depression from January 2009 to December 2014 were enrolled and randomly assigned into itopride group (32 cases) receiving itopride (50 mg/time, 3 times/d), deanxit group (33 cases) receiving deanxit (1 tablet/time, 2 times/d) and combination group (32 cases) receiving deanxit combined with itopride.Before and after 12 weeks of treatment, the reflux disease questionnaire (RDQ) score was used to assess the efficacy, and the Hamilton depression (HAMD) scale was used to assess the depression degree, the 36-item short form health survey (SF-36) was used to assess the life quality.Results After treatment, The RDQ symptom scores (including reflux, heartburn, acid reflux, noncardiac chest pain) and RDQ total scores were significantly decreased compared with those before treatment in itopride group [(0.98 ±0.61) scores vs (6.09 ± 1.63) scores, (0.98 ±0.62) scores vs (6.01 ± 1.74) scores, (0.81 ±0.34) scores vs (6.21 ±1.61) scores, (1.14±0.71) scores vs (5.92 ±1.41) scores, (3.91 ±0.64) scores vs (24.53 ±2.01) scores], deanxit group [(1.25 ±0.91) scores vs (5.87 ± 1.51) scores, (1.31 ±0.74) scores vs (6.02±1.85) scores, (1.01±0.64) scores vs (5.99 ± 1.71) scores, (1.18±0.76) scores vs (6.15 ±1.45) scores, (4.72 ± 0.85) scores vs (24.02 ± 1.93) scores] and combination group [(0.43 ± 0.35) scores vs (6.14±1.49) scores, (0.32±0.28) scores vs (6.11 ±1.98) scores, (0.29±0.24) scores vs (6.24±1.58) scores, (0.65 ± 0.53) scores vs (6.38 ± 1.43) scores, (1.64 ± 0.32) scores vs (24.98 ±1.95) scores] (P ＜0.05);the RDQ total score was significantly higher in deanxit group compared with that in itopride group, the RDQ symptom scores and total score were significantly lower in combination group compared with those in itopride group and deanxit group (P ＜ 0.05).The effective rates in itopride group and deanxit group had no significantly difference, which were both significantly lower than that in combination group [75.0％(24/32), 63.6％ (21/33) vs 90.6％ (29/32)] (P＜0.05).Compared with that before treatment, the HAMD score was significantly decreased after treatment in deanxit group [(12.4 ±6.2) scores vs (22.1 ± 1.9) scores]and combination group [(9.7 ± 6.8) scores vs (21.9 ± 1.8) scores] , significantly lower than that in itopride group after treatment [(20.3 ± 6.5) scores] (P ＜ 0.05).In SF-36 score, the item scores were improved except for physical limitation in all groups;the vitality, social function, emotional function and mental health scores were significantly higher in deanxit group and combination group compared with those in itopride group [(92 ± 7), (94 ± 7) scores vs (71 ± 6) scores, (90 ± 7) , (97 ± 5) scores vs (77 ± 6) scores, (80 ± 7) , (87 ± 6) scores vs (70 ± 6) scores, (80 ± 6), (83 ± 7) scores vs (72 ± 6) scores], the social function and emotional function scores in combination group were significaltly higher than those in deanxit group, in addition, the body pain and general health scores were also significantly higher in combination group compared with those in itopride group [(84±6) scores vs (78±6) scores, (78±6) scores vs (71 ±6) scores] (P＜0.05).Conclusion Deanxit combined with itopride treatment can significantly improve the quality of life and enhance the curative effect in NERD patients complicated with depression.%目的 探讨氟哌噻吨美利曲辛联合促胃动力药治疗伴抑郁的非糜烂性胃食管反流病(NERD)患者临床效果.方法 纳入2009年1月至2014年12月广西玉林市中医院NERD患者97例,采用随机数字表法分为3组.伊托必利组(32例),口服伊托必利50 mg/次,3次/d;氟哌噻吨美利曲辛组(33例),口服氟哌噻吨美利曲辛1片/次,2次/d;联合治疗组(32例),联合应用伊托必利和氟哌噻吨美利曲辛片,剂量同前.连续治疗12周.采用反流性疾病诊断问卷(RDQ)量表评价后疗效,采用汉密尔顿抑郁量表(HAMD)评价治疗前后抑郁状态,采用SF-36健康量表评价治疗前后生活质量.结果 治疗后伊托必利组、氟哌噻吨美利曲辛组和联合治疗组RDQ中反流、烧心、反酸、非心源性胸痛评分和总分均明显低于治疗前[伊托必利组:(0.98±0.61)分比(6.09±1.63)分,(0.98±0.62)分比(6.01 ±1.74)分,(0.81±0.34)分比(6.21±1.61)分,(1.14±0.71)分比(5.92±1.41)分,(3.91±0.64)分比(24.53 ±2.01)分;氟哌噻吨美利曲辛组:(1.25±0.91)分比(5.87±1.51)分,(1.31±0.74)分比(6.02±1.85)分,(1.叭±0.64)分比(5.99±1.71)分,(1.18±0.76)分比(6.15±1.45)分,(4.72±0.85)分比(24.02±1.93)分;联合治疗组:(0.43±0.35)分比(6.14±1.49)分,(0.32±0.28)分比(6.11±1.98)分,(0.29±0.24)分比(6.24±1.58)分,(0.65 ±0.53)分比(6.38±1.43)分,(1.64±0.32)分比(24.98±1.95)分](均P＜0.05),其中氟哌噻吨美利曲辛组治疗后RDQ总分高于伊托必利组,联合治疗组治疗后RDQ 4项症状评分与总分明显低于伊托必利组和氟哌噻吨美利曲辛组,差异均有统计学意义(均P ＜0.05).联合治疗组患者总有效率明显高于伊托必利组和氟哌噻吨美利曲辛组[90.6％ (29/32)比75.0％ (24/32)、63.6％ (21/33)] (P ＜0.05),伊托必利组和氟哌噻吨美利曲辛组比较差异无统计学意义(P＞0.05).氟哌噻吨美利曲辛组和联合治疗组患者治疗后HAMD评分明显低于治疗前[(12.4±6.2)分比(22.1±1.9)分,(9.7±6.8)分比(21.9±1.8)分]和伊托必利组治疗后[(20.3±6.5)分],差异均有统计学意义(均P＜0.05).3组治疗后SF-36各分项评分除生理职能评分外均获改善(P＜0.05),氟哌噻吨美利曲辛组和联合治疗组治疗后活力、社会功能、情感职能和精神健康评分明显高于伊托必利组[(92±7)、(94±7)分比(71±6)分,(90±7)、(97±5)分比(77±6)分,(80±7)、(87±6)分比(70±6)分,(80±6)、(83±7)分比(72±6)分],联合治疗组治疗后社会功能和情感职能评分明显高于氟哌噻吨美利曲辛组,联合治疗组治疗后躯体疼痛和总体健康评分明显高于伊托必利组[(84±6)分比(78±6)分,(78±6)分比(71±6)分],差异均有统计学意义(均P＜ 0.05).结论 氟哌噻吨美利曲辛联合伊托必利能够明显改善NERD伴抑郁患者的生活质量,提高疗效.
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