雷贝拉唑联合氟哌噻吨美利曲辛治疗非糜烂性胃食管反流病的临床观察

Clinical observation of rabeprazole combined with flupentixol and melitracen treatment to non-erosive gastroesophageal reflux disease

目的观察雷贝拉唑(波利特)联合氟哌噻吨美利曲辛(黛力新)治疗伴有抑郁和焦虑的非糜烂性胃食管反流病(NERD)的临床疗效。方法 NERD依据临床症状结合胃镜进行诊断,症状采用胃食管反流病诊断问卷(GERDQ)方法进行记录,抑郁和焦虑采用综合医院焦虑/抑郁量表(HADS);90例患者随机分为雷贝拉唑组(n=30)、氟哌噻吨美利曲辛组(n=30)和雷贝拉唑联合氟哌噻吨美利曲辛组(n=30),治疗共进行6周,疗效评价采用症状积分。结果雷贝拉唑和氟哌噻吨美利曲辛单独应用,对NERD均具有一定的治疗效果,两组在治疗后第1、2、4和6周对烧心和胸痛的缓解,雷贝拉唑比氟哌噻吨美利曲辛略好,但差异无统计学意义(P>0.05),雷贝拉唑治疗反酸优于氟哌噻吨美利曲辛。两药联用能更好地缓解NERD的症状,显效率为83.33%,明显高于雷贝拉唑组(33.33%)和氟哌噻吨美利曲辛组(16.67%)(P<0.01);两药联用总有效率为100%,亦明显高于雷贝拉唑组(76.67%)和氟哌噻吨美利曲辛组(63.33%)(P<0.01)。结论雷贝拉唑联合氟哌噻吨美利曲辛对伴有抑郁或焦虑的NERD有较佳的治疗效果,提示抑郁或焦虑状态影响NERD的疗效。

Objective To investigate the efficacy of rabeprazole combined with flupentixol and melitracen （Deanxit） in the treatment of non-erosive gastroesophageal reflux disease （NERD） with depression and anxiety. Methods The diagnosis of NERD was based on the results of clinical symptoms and endoscopy. GERDQ was used to evaluate clinical symptoms. The hospital anxiety and depressive scale （HADS） was used to evaluate depression and anxiety status. Ninety patients were randomly divided into rabeprazole group （~ =30）, Deanxit group （n =30）, and rabeprazole combined with Deanxit group （~ = 30）. Each group was treated for six weeks. The efficacy was evaluated by the symptom scores. Results There were some effects of rabeprazole or Deanxit alone on the improvement of symptoms of NERD. Although the effect of rabeprazole was better than Deanxit, the differences for the relieving heartburn and substemal pain between two groups at time point of l, 2, 4, and 6 week after treatment were not statistically significant （P 〉 0. 05）. For relieving the acid regurgitation, rabeprazole was better than Deanxit. For relieving the symptoms of NERD, the treatment of combining rabeprazole and Deanxit （obvious effective rate of 83.33% ） was better and faster than either rabeprazole （33.33%） or Deanxit （16. 67% ）（P 〈0. 01）. The total efficacy rate of rabeprazole and Deanxit group （100%） was higher than that of rabeprazole group （76.67%） or Deanxit group （63. 33% ）（P 〈0. 01）. Conclusion The efficacy of the treatment of combining rabeprazole and Deanxit for NERD with depression and anxiety is better. The results suggest that depression and anxiety have certain effects on the treatment of NERD.