文拉法辛与黛力新对难治性非糜烂性胃食管反流病患者的临床对照研究

Clinical study of venlafaxine and deanxit on patients with refractory non-erosive gastroesophageal reflux disease

目的观察并分析文拉法辛和黛力新对难治性非糜烂性胃食管反流病(NERD)的作用。方法将湖北省十堰市人民医院90例难治性NERD患者随机分为对照组、文拉法辛组及黛力新组,各组均为30例。对照组仅予以艾司奥美拉唑40 mg,2次/d,文拉法辛组予以艾司奥美拉唑后加文拉法辛25~75 mg,3次/d,黛力新组在给予艾司奥美拉唑的前提下加用黛力新10 mg,2次/d,共观察8周。使用胃食管反流病(GERD)问卷评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)在治疗开始前及治疗开始第2周后、第4周后、第8周后分别评分,观察各组胃食管反流症状及焦虑、抑郁变化。结果黛力新组及文拉法辛组在治疗2周后GERDQ、HAMD、HAMA评分均较治疗前降低(P<0.05),治疗4周后文拉法辛组和黛力新组GERDQ、HAMA和HAMD评分均低于对照组(P<0.05);治疗8周后,文拉法辛组及黛力新组的各组评分均低于治疗前及对照组(P<0.05),且文拉法辛组HAMA评分低于黛力新组(P<0.05)。结论文拉法辛及黛力新均对难治性NERD患者均有较好的疗效,且文拉法辛的抗焦虑作用强于黛力新。

【Objective】To observe and analyze the effects of venlafaxine and deanxit on refractory non-erosive gastroesophageal reflux disease(NERD).【Methods】Ninety patients with refractory NERD were randomly divided into control group(n=30),venlafaxine group(n=30)and deanxit group(n=30).The control group was only given esomeprazole 40 mg bid,venlafaxine group was given esmeprazole followed by venlafaxine(25-75)mg tid,and deanxit group was treated with 10 mg bid in addition to esomeprazole for 8 weeks.Gastroesophageal reflux disease questionnaire(GERDQ)score,Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score were used to observe the symptoms of gastroesophageal reflux and the changes of anxiety and depression in each group before and after 2,4 and 8 weeks of treatment.【Results】After 2 weeks of treatment,the scores of GERDQ,HAMD and HAMA in deanxit group and venlafaxine group were significantly lower than those before treatment(P<0.05).After 4 weeks of treatment,the scores of GERDQ,HAMA and HAMD in venlafaxine group and deanxit group were significantly lower than those in the control group(P<0.05).After 8 weeks of treatment,the scores of patients in venlafaxine group and deanxit group were significantly lower than those before treatment and control group(P<0.05),and the HAMA score of venlafaxine group was significantly lower than that of deanxit group(P<0.05).【Conclusion】Both venlafaxine and deanxin are effective in the treatment of refractory NERD,and the anti-anxiety effect of venlafaxine is stronger than that of deanxit.