氟哌噻吨美利曲辛片联合舒肝解郁胶囊治疗难治性胃食管反流的效果

Effect of flupentixol and melitracen tablets combined with Shugan Jieyu Capsule in the treatment of refractory gastroesophageal reflux

目的探讨应用氟哌噻吨美利曲辛片联合舒肝解郁胶囊治疗难治性胃食管反流(GERD)的临床效果。方法共收集本院消化内科收治的90例难治性GERD患者,采用随机数表法分为对照组和研究组,各45例。对照组给予质子泵抑制剂(PPIs)优化方案治疗,研究组在对照组基础上给予氟哌噻吨美利曲辛片联合舒肝解郁胶囊治疗,均持续治疗12周且治疗期密切随访。统计2组治疗前、治疗6、12周的胃食管反流病症状评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分,并评估2组临床疗效、安全性。结果对照组无退出失访病例,研究组1例中途退出。2组反流性疾病问卷(RDQ)评分、HAMD、HAMA评分均呈逐渐下降趋势;治疗6、12周时,2组RDQ评分、HAMD、HAMA评分均显著低于治疗前(P<0.05),且研究组治疗6、12周时上述评分显著低于对照组,差异均有统计学意义(P<0.05)。研究组治疗总有效率为95.45%,显著高于对照组的80.00%,差异有统计学意义(P<0.05)。2组治疗期间仅有少量轻微不适症状,不影响持续治疗。结论常规PPIs优化方案治疗基础上采用氟哌噻吨美利曲辛片联合舒肝解郁胶囊,能有效缓解难治性GERD的临床症状和改善精神状态,是一种疗效显著、安全性高的可靠疗法。

Objective To investigate the clinical effect of Flupentixol and Melitracen Tablets combined with Shugan Jieyu Capsule in the treatment of refractory gastroesophageal reflux disease(GERD).Methods A total of 90 patients with refractory GERD admitted to Department of Digestion were divided into control group and study group according to random number table method,with 45 cases in each group.The control group was treated with optimized treatment by proton pump inhibitors(PPIs),the study group was treated with Flupentixol and Melitracen Tablets combined with Shugan Jieyu Capsule on the basis of the control group,the treatments of both groups lasted for 12 weeks and the patients were followed up closely.The scores of GERD symptoms,Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)before treatment,and at 6 and 12 weeks after treatment were compared.The clinical efficacy and safety of the two groups were evaluated.Results There was no dropout case in the control group and 1 case removed from the study group.The Reflux Disease Questionnaire(RDQ),HAMD and HAMA scores of the two groups showed a gradual downward trend.The RDQ,HAMD and HAMA scores at 6 and 12 weeks after treatment were significantly lower than before treatment(P<0.05),and the study group was significantly lower than that in the control group(P<0.05).The total effective rate of the study group was significantly higher than that of the control group(95.45%vs.80.00%,P<0.05).There were only a few mild discomfort symptoms in the two groups during the treatment period,which did not affect the continuous treatment.Conclusion Flupentixol and Melitracen Tablets combined with Shugan Jieyu Capsule on the basis of routine optimized treatment by PPIs can effectively relieve the clinical symptoms of refractory GERD and improve the mental state,which is a reliable therapy with remarkable curative effect and high safety.