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疗效

Curative Effects of Flupenthixol Melitracen Combined with Proton Pump Inhibitor for the Treatment of Non- erosive Gastroesophageal Reflux Disease with Anxiety and Depression

目的研究氟哌噻吨美利曲辛联合质子泵抑制剂（PPI）治疗伴焦虑抑郁症状的非糜烂性胃食管反流病（NERD）的临床疗效。方法将2012年1月～2014年9月笔者医院消化内科治疗的伴焦虑抑郁症状的NERD患者90例，采用数字表法随机分为联合组和对照组，各45例。对照组采用PPI埃索美拉唑治疗（每日早晨空腹口服），同时辅以心理疏导，治疗组在此基础上给予氟哌噻吨美利曲辛片（早餐、午餐后各1次），疗程均为8周。比较分析两组的临床疗效、焦虑抑郁及睡眠质量的改善情况、不良反应及复发情况。结果联合组总有效率84．4％，显著高于对照组总有效率66．7％（P〉0．05）；治疗后，两组HAMD、HAMA评分均有明显改善，联合组HAMD、HAMA、PSGI评分显著低于对照组（P〈0．05）；联合组的复发率为8．9％，显著低于对照组24．4％（P〈0．05）；两组治疗期间均无严重不良反应。结论在PPI常规治疗的基础上，联合氟哌噻吨美利曲辛治疗伴焦虑抑郁的NERD患者的可改善躯体不适症状，缓解焦虑抑郁等负性情绪及睡眠状况，降低复发。

Objective To investigate the clinical effect of flupenthixol melitracen combined with proton pump inhibitor（PPI） for the treatment of non - erosive gastroesophageal reflux disease （NERD） with anxiety and depression. Methods Ninty NERD patients who were admitted to the department of gastroenterology in our hospital from Jan 2012 to Sep 2014 were randomly divided into two groups. Control group（n = 45） was given esomeprazole（orally per day before breakfast）, and supported by psychological aids, combined group （n = 45 ） was given flupentixol melitracen additionally（ after breakfast, lunch, twice a day）. The treatment courses were all g weeks. The clinical effect, symptoms of anxiety and depression and sleep, adverse reaction and recurrence between two groups were compared. Results There was significant difference in the total effective rate between the two group （84.4% % vs 66.7% ） （P 〈 0.05 ）. After treatment, the HAMD, HAMA, PSGI score in both groups were all remarkably reduced（P 〈0.05） , and the HAMD, HAMA, PSGI score in combined group were significantly improved than those in control treatment（P 〈 0.05）. The recurrence rate in combined group was 8.9% , which was significantly lower than 24.4% in control group（ P 〈 0.05 ）. There was no serious adverse effects in both groups during the treatment. Conclusion Combined use of flupenthixol melitracen with conventional PPI treatment for the treatment of NERD with anxiety and depres- sion can eliminate physical discomfort, improve anxiety, depression and sleep disorders, reduce the recurrence.