抗焦虚抑郁药物联合PPI治疗难治性反流性食管炎的临床研究

发布时间：2018-04-23 00:26

本文选题：抗焦虑抑郁 + 难治性反流性食管炎　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：探讨抗焦虑抑郁药物（氟哌噻吨美利曲辛）联合质子泵抑制剂（PPI）治疗伴有焦虑和/或抑郁的难治性反流性食管炎(RRE)患者的临床疗效。方法：将123例RRE伴焦虑和/或抑郁状态的患者随机分为两组，均给予埃索美拉唑镁肠溶片40mg，qd，双盲给药，1组服用1号药物1片，bid，2组服用2号药物1片，bid，疗程4w结束后，1号药物揭底显示为氟哌噻吨美利曲辛，1组为试验组（65例），2号药物为安慰剂，2组为对照组（58例），治疗过程中运用反流性疾病问卷量表（RDQ）、医院焦虑抑郁量表（HADS）及胃镜检查，分别评估两组治疗前后临床症状、焦虑抑郁状况及胃镜下分级变化情况，，密切观察患者临床症状及焦虑和/或抑郁状态的变化情况、及时处理治疗过程中出现的不良反应。结果：治疗4w后，试验组的RDQ分值较对照组显著降低，试验组中：23例（35.38%）不适症状几乎完全缓解，疗效显著；30例（46.15%）患者治疗后症状分值较前明显降低，治疗有效，仅12例（18.46%）患者未见明显疗效，其有效率为81.53%。对照组的分值下降程度无明显改善，仅6例症状分值较前有所下降，大多数（81.54%）患者未见明显疗效，其有效率为10.34%，试验组有效率远高于对照组，两组差异有统计学意义（P＜0.01）。试验组焦虑(t=-10.69)、抑郁(t=-12.57)情况较对照组改善明显，两组差异有统计学意义（P＜0.05）。试验组和对照组在胃镜下分级无统计学差异（P＞0.05）。试验组6例患者轻度口干和便秘，尚无患者出现视物模糊等其他特殊不适；经过1-2周适应期，患者口干症状自行消失，仅2例患者的便秘需要加用缓泻剂，经积极处理后完全缓解，对照组无明显的不良反应。结论：氟哌噻吨美利曲辛联合PPI治疗伴有焦虑抑郁的RRE患者短期疗效显著，可明显改善患者临床症状及焦虑、抑郁状态，且无严重不良反应，值得在临床工作中推广应用。
[Abstract]:Objective: to investigate the clinical efficacy of flupperidazole (droperidazole) combined with proton pump inhibitor (PPI) in the treatment of refractory reflux esophagitis with anxiety and / or depression. Methods: 123 RRE patients with anxiety and / or depression were randomly divided into two groups. All patients were given esomeprazole magnesium enteric-coated tablets 40 mg / g QD, group 1 was given 1 tablet of No. 1 drug and group 2 was given 2 tablets of bidbidine. After 4 weeks of treatment, group 1 was shown to be dropermethothioate meritriaxine 1 group (65 cases). The control group (n = 58) was treated with the reflux disease questionnaire (RDQN), the hospital anxiety and depression scale (HADS) and gastroscopy. Before and after treatment, the clinical symptoms, anxiety and depression status of the two groups were evaluated, and the changes of the clinical symptoms, anxiety and / or depression state of the patients were closely observed, and the adverse reactions in the course of treatment were dealt with in a timely manner. Results: after 4 weeks of treatment, the scores of RDQ in the trial group were significantly lower than those in the control group. The effective rate was 81.53. There was no obvious improvement in the score of the control group, only 6 cases of the symptom score were lower than before, most of the patients had no obvious curative effect, the effective rate was 10.34. The effective rate of the experimental group was much higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.01). The anxiety and depression in the test group were significantly improved than those in the control group (P < 0.05). There was no statistical difference between the experimental group and the control group under gastroscopy (P > 0.05). In the test group, 6 patients had mild dry mouth and constipation, and no other special discomfort such as blurred vision appeared in the patients. After 1-2 weeks of adaptation, the symptoms of dry mouth disappeared by themselves, and only 2 patients needed to be treated with laxative agent for constipation. After positive treatment, there was no obvious adverse reaction in the control group. Conclusion: the short-term curative effect of flupantimetixine combined with PPI in the treatment of RRE patients with anxiety and depression is significant. It can obviously improve the clinical symptoms, anxiety and depression state of the patients, and there is no serious adverse reaction. It is worth popularizing and applying in clinical work.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571

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