不同方案对Hp阳性伴焦虑抑郁FD患者的临床疗效研究

Effects of different treatment regimens on functional dyspepsia patients combined with Helicobacter pylori infection and mild to moderate anxiety and depression

目的分析不同治疗方案对幽门螺杆菌(Hp)阳性伴轻中度焦虑抑郁的功能性消化不良(FD)患者的疗效。方法于2018年6月至2019年6月,将90例Hp阳性伴轻中度焦虑抑郁的FD患者随机分为A、B、C组。A组予以四联Hp根除治疗2周后,继续予以抑酸治疗4周;B组予以氟哌噻吨美利曲辛片治疗6周;C组予以四联Hp根除治疗2周,同时联合氟哌噻吨美利曲辛片治疗6周。于治疗前、治疗6周后,评估消化不良症状积分、焦虑评分、抑郁评分及生活质量评分。结果与治疗前相比,A、B、C组消化道不良症状平均积分均降低(P<0.05),症状改善总有效率分别为16.67%、82.00%、83.33%;A组焦虑、抑郁及生活质量评分无明显改变(P>0.05),B、C组焦虑、抑郁评分显著降低、生活质量评分明显升高(P<0.05)。治疗6周后,B、C组各量表积分与A组比较差异有统计学意义(P<0.05),而B、C组间差异无统计学意义(P>0.05)。结论对于伴焦虑抑郁的Hp阳性FD患者,常规Hp根除治疗对症状改善有限,而抗焦虑抑郁治疗可有效改善症状,且患者获益程度不亚于抗焦虑抑郁联合Hp根除治疗。

Objective To observe the effects of different treatment regimens on clinical symptoms and quality of life in patients with functional dyspepsia(FD)combined with Helicobacter pylori(Hp)infection and mild to moderate anxiety and depression.Methods From Jun.2018 to Jun.2019,90 FD patients with Hp infection and mild to moderate anxiety and depression were randomly divided into group A,B,and C.Group A was treated with quadruple Hp eradication treatment for 2 weeks,and then continued to be treated with antacid drug for 4 weeks.Group B was treated with flupentixol and melitracen tablets for 6 weeks.Group C was treated with quadruple Hp eradication treatment for 2 weeks and at the same time treated with flupentixol and melitracen tablets for 6 weeks.The dyspepsia symptom score,anxiety score,depression score,and quality of life score were evaluated before treatment and after 6 weeks of treatment.Results Compared with before treatment,the average scores of dyspepsia symptom was reduced in group A,B and C(P<0.05),and the total effective rate on dyspepsia symptoms was 16.67%,82.00%and 83.33%.After 6 weeks of treatment,there was no significant change of anxiety,depression and quality of life scores in group A(P>0.05),the scores of anxiety and depression in group B and C were significantly lower,and the quality of life score was significantly higher(P<0.05).Compared with group A,there were significant differences of all the scores in group B and group C after 6 weeks of treatment(P<0.05),but there was no significant difference between group B and group C(P>0.05).Conclusion For patients with FD,combined with Hp infection and mild to moderate anxiety and depression,routine Hp eradication therapy might be with limited improvement in symptoms,while anti-anxiety or depression treatment could effectively improve the clinical symptoms,which might have the same effect with anti-anxiety or depression treatment combined with Hp eradication treatment.