Influence of flupentixol and melitracen tablets combined with Shugan Jieyu Capsule on the efficiency and status of anxiety and depression in patients with refractory gastroesophageal reflux
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摘要:目的 探讨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 选取90例难治性GERD患者, 采用随机数字表法分为对照组与研究组，每组45例。对照组给予兰索拉唑肠溶胶囊+枸橼酸莫沙必利治疗，研究组在对照组基础上给予氟哌噻吨美利曲辛片(黛力新)联合舒肝解郁胶囊治疗。比较2组治疗前、治疗6周、治疗12周的胃食管反流病症状评分、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA), 并评估2组临床疗效和安全性。结果 研究组有1例中途退出。2组治疗6周、12周时反流性疾病问卷(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周、12周时上述评分显著低于对照组(P < 0.05)。研究组治疗总有效率95.45%, 显著高于对照组80.00%(P < 0.05)。2组治疗期间仅有少量轻微不适症状。结论 常规质子泵抑制剂优化方案治疗基础上加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，改善精神状态。Abstract:Objective To investigate the clinical effect of flupentixol and melitracen tablets combined with Shugan Jieyu capsule on the treatment of patients with refractory gastroesophageal reflux disease (GERD).Methods A total of 90 patients with refractory GERD were randomly divide into control group and research group, with 45 cases in each group. The control group was treated with lansoprazole enteric-coated capsules plus mosapride citrate, while the research group was treated with flupentixol and melitracen tablets (Delixin) and Shugan Jieyu Capsules on the basis of the control group. The scores of symptoms of GERD, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were compared before treatment and 6, 12 weeks after treatment between two groups, and the clinical efficacy and safety was evaluated between two groups.Results There was 1 case of dropout in the research group. The scores of Reflux Disease Questionnaire (RDQ), HAMD and HAMA in both groups at 6 and 12 weeks of treatment were significantly lower than those before treatment (P < 0.05), and these indexes of the research group at 6 and 12 weeks of treatment were significantly lower than those of the control group (P < 0.05). The total effective rate was 95.45% in the researchgroup, which was significantly higher than 80.00% in the control group (P < 0.05). There were only a few mild discomfort symptoms in the two groups during the treatment period.Conclusion On the basis of routine PPI optimal treatment, flupentixol andmelitracen tablets combined with Shugan Jieyu Capsule can effectively relieve the clinical symptoms of refractory GERD and improve the mental state.
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表 1 2组不同时点胃食管反流病症状RDQ评分比较(x±s)分
组别 n 胃食管反流病症状RDQ评分 治疗前 治疗6周 治疗12周 对照组 45 8.72±2.37 5.18±1.48* 3.21±1.04* 研究组 44 8.59±2.51 4.23±1.17*# 1.73±0.57*# 与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。 
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表 2 2组不同时点精神状态HAMD、HAMA评分比较(x±s)
分 组别 n HAMD评分 HAMA评分 治疗前 治疗6周 治疗12周 治疗前 治疗6周 治疗12周 对照组 45 25.91±7.24 15.32±5.60* 10.35±3.29* 27.89±8.53 18.72±6.28* 13.57±5.71* 研究组 44 26.07±7.43 11.84±4.37*# 7.04±2.38*# 28.04±8.47 14.38±5.15*# 8.03±3.14*#
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表 3 2组治疗效果比较[n(%)]
组别 n 痊愈 显效 有效 无效 总有效 对照组 45 3(6.67) 15(33.33) 18(40.00) 9(20.00) 36(80.00) 研究组 44 8(18.18) 19(43.18) 15(34.09) 2(4.55) 42(95.45)* 与对照组比较, *P < 0.05。
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