氟哌噻吨美利曲辛片联合埃索美拉唑对伴有焦虑及抑郁状态的非糜烂性胃食管反流病临床疗效观察

发布时间：2018-03-03 15:26

本文选题：非糜烂性胃食管反流病　切入点：胃食管反流病量表　出处：《华中科技大学》2014年博士论文　论文类型：学位论文

【摘要】：第一部分氟哌噻吨美利曲辛片联合埃索美拉唑对伴有焦虑及抑郁状态的NERD患者胃食管反流症状的疗效目的：通过氟哌噻吨美利曲辛片联合埃索美拉唑治疗伴有焦虑及抑郁状态NERD患者,观察抗焦虑抑郁药物对NERD患者反流症状的疗效,探讨氟哌噻吨美利曲辛片对伴有抑郁及焦虑状态NERD患者的疗效。方法：84例伴有焦虑及抑郁状态NERD患者随机分为两组,对照组(埃索美拉唑组)40例,治疗组(氟哌噻吨美利曲辛片联合埃索美拉唑组)44例。对照组给予埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服,治疗组给予氟哌噻吨美利曲辛片10mg,每日早午餐后口服,同时服用埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服。疗程8周,并于治疗前及治疗后1、2、4、8周给予胃食管反流病量表(Gastroesophageal Reflux Disease Questionnaire,GERDQ)评分。结果：1.治疗前治疗组与对照组GERDQ评分无统计学差异(P0.05)； 2.治疗后1,2,4,8周,治疗组GERDQ评分明显低于对照组(P0.05),两组GERDQ评分在治疗一周后均呈下降趋势,治疗组GERDQ评分达到正常,对照组仍高于正常水平； 3.两组GERDQ评分在治疗后2,4,8周时仍维持在治疗后1周水平,各组间相比无统计学差异(P0.05)； 4.治疗组生活质量评分在治疗前与治疗后有统计学差异(P0.05),对照组生活质量评分在治疗前与治疗后无统计学差异(P0.05) 结论：氟哌噻吨美利曲辛片联合埃索美拉唑较单纯使用埃索美拉唑治疗对伴有抑郁及焦虑状态的NERD患者更为有效,可明显改善NERD患者的烧心,反酸等反流症状, 目的：通过氟哌噻吨美利曲辛片联合埃索美拉唑治疗伴有焦虑及抑郁状态NERD患者,观察抗焦虑抑郁药物对NERD患者HAD, HAM-D及HAM-A评分改善情况,探讨氟哌噻吨美利曲辛片对伴有抑郁及焦虑状态NERD患者焦虑抑郁状态的影响。方法：84例伴有焦虑及抑郁状态NERD患者随机分为两组,对照组(埃索美拉唑组)40例,治疗组(氟哌噻吨美利曲辛片联合埃索美拉唑组)44例。对照组给予埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服,治疗组给予氟哌噻吨美利曲辛片10mg,每日早午餐后口服,同时服用埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服。疗程8周,并于治疗前及治疗后1、2、4、8周给予综合医院焦虑/抑郁量表(Hospital Anxiety and Depression, HAD),汉密尔顿焦虑量表(Hamilton Anxiety rating scale, HAMA),汉密尔顿抑郁量表(Hamilton Depression rating scale, HAMD)评分。结果：治疗前治疗组与对照组HAD, HAM-D及HAM-A评分均无统计学差异(P0.05),治疗后1,2,4,8周,治疗组HAD, HAM-D及HAM-A评分明显低于对照组(P0.05),两组HAD, HAM-D及HAM-A评分均呈下降趋势,治疗组下降较明显,治疗组HAD, HAM-D及HAM-A评分治疗前与治疗后8周相比均有统计学差异(P0.05),对照组HAM-D及HAM-A评分治疗前与治疗后8周相比均有统计学差异(P0.05), HAD评分治疗前与治疗后8周相比无统计学差异(P0.05)。结论：氟哌噻吨美利曲辛片联合埃索美拉唑较单独使用埃索美拉唑对伴有抑郁及焦虑状态的NERD患者更为有效,并可明显降低NERD患者的各项心理评分,他评量表HAM-D, HAM-A较自评量表HAD在NERD伴随抑郁焦虑状态的心理测评上更为敏感。目的：通过氟哌噻吨美利曲辛片联合埃索美拉唑治疗伴有焦虑及抑郁状态NERD患者,观察抗焦虑抑郁药物对NERD患者HAM-D评分中各因子的影响,探讨氟哌噻吨美利曲辛片对伴有抑郁及焦虑状态NERD状态作用。方法：84例伴有焦虑及抑郁状态NERD患者随机分为两组,对照组(埃索美拉唑组)40例,治疗组(氟哌噻吨美利曲辛片联合埃索美拉唑组)44例。对照组给予埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服,治疗组给予氟哌噻吨美利曲辛片10mg,每日早午餐后口服,同时服用埃索美拉唑镁肠溶片20mg,每天早晚餐前20分钟口服。疗程8周,并于治疗前及治疗后1、2、4、8周给予汉密尔顿抑郁量表评分。结果：治疗前两组HAM-D各因子评分均无统计学差异(P0.05),治疗8周后,两组体重,日夜变化,绝望感因子评分无统计学差异(P0.05),治疗组焦虑/躯体化,认知障碍,迟缓,睡眠障碍等评分较对照组明显减(P0.05) 结论：氟哌噻吨美利曲辛片联合埃索美拉唑对伴有抑郁及焦虑状态的NERD患者较单纯应用埃索美拉唑更为有效,并可明显改善NERD患者焦虑/躯体化,认知障碍,迟缓,睡眠障碍等精神症状,显著改善患者的生活质量。
[Abstract]:The first part of the Flupentixol and Melitracen Tablets effect of esomeprazole combined with anxiety and depression in patients with NERD gastric reflux symptom
Objective: through Flupentixol and Melitracen Tablets combined with esomeprazole treatment of anxiety and depression in patients with NERD, to observe the anti anxiety depression drug on the curative effect of NERD patients with reflux symptoms, to explore the effect of Flupentixol and Melitracen Tablets associated with depression and anxiety in patients with NERD.
Methods: 84 patients with anxiety and depression status of patients with NERD were randomly divided into two groups, control group (esomeprazole group) 40 cases, treatment group (Flupentixol and Melitracen Tablets esomeprazole group) 44 cases. The control group was given the Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally, the treatment group was given the Flupentixol and Melitracen Tablets 10mg, daily brunch after oral administration, while taking Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally. After 8 weeks of treatment, and gastroesophageal reflux disease questionnaire in 1,2,4,8 weeks before and after treatment (Gastroesophageal Reflux Disease Questionnaire, GERDQ) score.
Results: 1. before treatment, there was no significant difference in GERDQ score between the treatment group and the control group (P0.05).
1,2,4,8 2. weeks after treatment, the GERDQ score of treatment group was significantly lower than the control group (P0.05), two groups of GERDQ score decreased in a week after treatment, GERDQ score of the treatment group reached the normal control group was still higher than normal level;
3. two groups of GERDQ scores were still maintained at 1 weeks after treatment at 2,4,8 weeks after treatment, and there was no statistical difference between each group (P0.05).
4., the quality of life score in the treatment group was statistically different before and after treatment (P0.05), while the quality of life score in the control group was not statistically different before and after treatment (P0.05).
Conclusion: Flupentixol and Melitracen Tablets combined with esomeprazole was better than the simple use of Esomeprazole in the treatment of depression and anxiety in patients with NERD is more effective, can significantly improve the NERD of patients with heartburn, acid regurgitation symptoms,
Objective: through Flupentixol and Melitracen Tablets combined with esomeprazole treatment of anxiety and depression in patients with NERD, to observe the anti anxiety depression drug on patients with NERD HAD, HAM-D and HAM-A scores, explore the impact of Flupentixol and Melitracen Tablets on the anxiety and depression of patients with NERD associated with depression and anxiety.
Methods: 84 patients with anxiety and depression status of patients with NERD were randomly divided into two groups, control group (esomeprazole group) 40 cases, treatment group (Flupentixol and Melitracen Tablets esomeprazole group) 44 cases. The control group was given the Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally, the treatment group was given the Flupentixol and Melitracen Tablets 10mg, daily brunch after oral administration, while taking Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally. The course of treatment was 8 weeks, and give the hospital anxiety / depression scale in 1,2,4,8 weeks before and after treatment (Hospital Anxiety and Depression, HAD), Hamilton Anxiety Scale (Hamilton Anxiety rating scale, HAMA), Hamilton Depression Scale (Hamilton Depression rating scale, HAMD) score.
Results: before treatment, the treatment group and the control group HAD were no significant difference between the HAM-D and HAM-A score (P0.05), 1,2,4,8 weeks after treatment, the treatment group HAD, HAM-D and HAM-A were significantly lower than the control group (P0.05), two groups of HAD, HAM-D and HAM-A were decreased, the treatment group decreased obviously, treatment group HAD, HAM-D and HAM-A score before treatment and 8 weeks after treatment compared statistically significant difference (P0.05), control group HAM-D and HAM-A score before treatment and 8 weeks after treatment compared statistically significant difference (P0.05), HAD score before treatment and after 8 weeks of treatment compared with no significant difference (P0.05).
Conclusion: Flupentixol and Melitracen Tablets combined with esomeprazole compared with esomeprazole for patients with depression and anxiety state of the patients with NERD is more effective, and can significantly reduce the psychological score of patients with NERD, his rating scale HAM-D, HAM-A self rating scale HAD in NERD with the psychological assessment of depression and anxiety is more sensitive.
Objective: through Flupentixol and Melitracen Tablets combined with esomeprazole treatment of anxiety and depression in patients with NERD, to observe the effect of anti anxiety drugs on the factor scores in HAM-D patients with NERD, to investigate Flupentixol and Melitracen Tablets associated with depression and anxiety state of NERD.
Methods: 84 patients with anxiety and depression status of patients with NERD were randomly divided into two groups, control group (esomeprazole group) 40 cases, treatment group (Flupentixol and Melitracen Tablets esomeprazole group) 44 cases. The control group was given the Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally, the treatment group was given the Flupentixol and Melitracen Tablets 10mg, daily brunch after oral administration, while taking Esomeprazole Magnesium Enteric-coated Tablets 20mg, a day sooner or later 20 minutes before a meal orally. The course of treatment was 8 weeks, and give Hamilton Depression Scale score in 1,2,4,8 weeks before and after the treatment.
Results: before treatment, the factors of HAM-D scores of the two groups were not statistically significant (P0.05), after 8 weeks of treatment, two groups of weight, diurnal variation, hopelessness factor score was no significant difference (P0.05), treatment group, anxiety / somatization, cognitive impairment, retardation, sleep disorder scores significantly decreased compared with the control group (P0.05)
Conclusion: Flupentixol and Melitracen Tablets esomeprazole combined with depression and anxiety in patients with NERD compared with the simple application of esomeprazole is more effective, and can significantly improve the anxiety / NERD in patients with somatization, cognitive impairment, mental retardation, sleep disorders and other symptoms, improve the quality of life of patients.

【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R57;R749

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