氟哌噻吨美利曲辛联合埃索美拉唑、莫沙必利治疗难治性胃食管反流病的疗效观察

Efficacy of flupentixol melitracen joint esomeprazole,mosapride in the treatment of refractory gastroesopha-geal reflux disease

目的：探讨氟哌噻吨美利曲辛联合埃索美拉唑、枸橼酸莫沙必利治疗难治性胃食管反流病的临床疗效。方法难治性胃食管反流病患者80例，随机数字表法分为对照组及观察组，各40例。两组患者均给予口服埃索美拉唑及枸橼酸莫沙必利治疗，观察组在对照组治疗的基础上加用氟哌噻吨美利曲辛。4周为1个疗程，两组患者均治疗2个疗程。记录两组患者临床疗效，治疗前后 RDQ 评分及抑郁焦虑积分变化，记录治疗过程中的不良反应。结果观察组总有效率82．50％，对照组总有效率为70．00％，观察组临床疗效高于对照组，差异有统计学意义（χ2＝3．660，P ＜0．05），两组患者治疗前 SAS，SDS 积分及 RDQ 水平相比较差异无统计学意义（P ＞0．05）。治疗后，对照组 RDQ 中症状积分为（8．12±0．89）分，频率积分为（7．70±1．00）分，与治疗前相比差异有统计学意义（t ＝4．70、6．37，均 P ＜0．05），且治疗后观察组症状积分（5．21±0．45）分、频率积分（4．71±0．78）分，明显低于对照组的（8．12±0．89）分、（7．70±1．00）分（t ＝1．81、1．81，均 P ＜0．05）；治疗后，对照组 SAS 积分为（49．12±5．89）分，SDS 积分为（50．30±6．00）分，与治疗前相比差异均有统计学意义（t ＝1．81、1．81，均 P ＜0．05），且治疗后观察组 SAS 积分（41．21±5．45）分，SDS 积分（43．71±5．78）分，明显低于对照组（t ＝2．30、1．91，均 P ＜0．05）；且在治疗过程中两组患者不良反应发生情况类似，未发现严重不良反应。结论氟哌噻吨美利曲辛联合埃索美拉唑、枸橼酸莫沙必利治疗难治性胃食管反流病，临床疗效显著，可以有效改善患者临床症状及抑郁焦虑评分，且无明显不良反应发生，值得临床推广应用。

Objective To evaluate the clinical efficacy of flupentixol melitracen joint esomeprazole, mosapride in the treatment of refractory gastroesophageal reflux disease.Methods 80 patients with refractory gastroe-sophageal reflux disease were randomly divided into control group and observation group,40 cases in each group.Twogroups of patients were given oral esomeprazole and mosapride treatment,the observation group was treated with flu-pentixol melitracen on the basis of control group.4 weeks for a course of treatment,patients were treated for 2 courses. The clinical efficacy of the two groups,the depression and anxiety RDQ score before and after treatment,the adverse reactions were recorded.Results The total effective rate of the observation group was 82.50%,which was signifi-cantly higher than 70.00% of the control group,the difference was statistically significant （χ2 =3.660,P 〈0.05）. Before treatment,SAS,SDS score and RDQ level between the two groups had no significant difference （all P 〉0.05）. After treatment,the RDQ in symptom score and frequency integrator of the control group were （8.12 ±0.89）points, （7.70 ±1.00）points,compared with before treatment,the differences were significant （t =4.70,6.37,all P 〈0.05）,and those of the observation group were （5.21 ±0.45）points,（4.71 ±0.78）points,which were significantly lower than those of the control group,the differences were statistically significant （t =1.81,1.81,all P 〈0.05）.After treatment,the SAS score and SDS score of control group were （49.12 ±5.89）points,（50.30 ±6.00）points,com-pared with before treatment,the differences were significant （t =1.81,1.81,all P 〈0.05）,and those of the observa-tion group were （41.21 ±5.45）,（43.71 ±5.78）,which were significantly lower than the control group （t =2.30, 1.91,all P 〈0.05）.During the treatment,the adverse events in the two groups were similar,no serious adverse reac-tions were observed.Conclusion Flupentixol melitracen joint esomeprazole,mosapride in the treatment of refractory gastroesophageal reflux disease has significant clinical effect,can effectively improve the clinical symptoms of depres-sion and anxiety scores,and without significant adverse reactions,it is worthy of clinical application.