氟哌噻吨美利曲辛片辅助治疗糜烂反流性食管炎伴心理障碍患者的疗效观察
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摘要
目的:观察氟哌噻吨美利曲辛片辅助治疗糜烂反流性食管炎(RE)伴心理障碍患者的疗效。方法:纳入184例糜烂RE伴焦虑抑郁患者,采用密封信封法随机按1:1比例分组,92例给予RE常规治疗者归为对照组,92例给予RE常规+氟哌噻吨美利曲辛片治疗者归为观察组,比较两组疗效。结果:两组HAMA评分(t=40.12,20.36;P<0.01)、HAMD评分(t=36.16,19.92;P<0.01)均显著降低治疗前,且治疗后组间差异显著(t=-13.22,12.29;P<0.01);治疗后两组GredQ评分均显著降低(t=55.84,42.03;P<0.01),治疗后组间差异显著(t=-12.10,P<0.01);观察组症状改善总有效率96.74%,对照组86.96%,差异具有统计学意义(χ~2=5.88,P<0.05);治疗后两组PSQI评分显著降低(t=25.16,15.60;P<0.01),治疗后组间差异显著(t=-8.11,P<0.01);观察组食管糜烂程度改善总有效率97.83%,对照组88.04%,差异具有统计学意义(χ~2=6.70,P<0.01)。结论:糜烂反流性食管炎患者均伴有不同程度焦虑抑郁症状,辅助心理对症治疗后,可明显提高疗效。
Objective: To study the adjuvant clinical effects of flupentixol and melitracen tablets on psychological disorder patients with rheumatoid esophagitis( RE).Methods: A total of 184 patients with rheumatoid arthritis complicated with anxiety and depression were enrolled in the study and randomly divided into the two groups with 1: 1 ratio according to the sealed envelopes method,and 92 patients treated with RE conventional therapy were selected as the control group and other 92 patients given RE routine therapy and flupentixol and melitracen tablets were classified as the observation group.And the curative effects were compared between the two groups.Results: The HAMA scores( t = 40.12,20.36; P< 0.01),the HAMD scores( t = 36.16,19.92; P<0.01) of the two groups were significantly lower than those before treatment,and the differences between them were significant after treatment( t =-13. 22,12.29; P < 0. 01). After treatment,the GredQ scores of the two groups were significantly decreased( t = 55.84,42.03; P<0.01),and the difference was significant between the two groups( t=-12.10,P<0.01).The total effective rate was 96.74% in the observation group and 86.96% in the control group,and the difference was statistically significant( χ~2= 5.88,P<0.05). After treatment,the PSQI score were significantly decreased( t =25.16,15.60; P<0.01),and there was significant difference between the two groups( t =-8.11,P< 0.01). The total effective rate was 97.83% in the observation group and 88.04% in the control group( χ~2= 6.70,P<0.01). Conclusion: Patients with rheumatoid esophagitis are accompanied by varying degrees of anxiety and depression symptoms. And the adjuvant psychological symptomatic treatment can significantly improve the efficacy.
Objective: To study the adjuvant clinical effects of flupentixol and melitracen tablets on psychological disorder patients with rheumatoid esophagitis( RE).Methods: A total of 184 patients with rheumatoid arthritis complicated with anxiety and depression were enrolled in the study and randomly divided into the two groups with 1: 1 ratio according to the sealed envelopes method,and 92 patients treated with RE conventional therapy were selected as the control group and other 92 patients given RE routine therapy and flupentixol and melitracen tablets were classified as the observation group.And the curative effects were compared between the two groups.Results: The HAMA scores( t = 40.12,20.36; P< 0.01),the HAMD scores( t = 36.16,19.92; P<0.01) of the two groups were significantly lower than those before treatment,and the differences between them were significant after treatment( t =-13. 22,12.29; P < 0. 01). After treatment,the GredQ scores of the two groups were significantly decreased( t = 55.84,42.03; P<0.01),and the difference was significant between the two groups( t=-12.10,P<0.01).The total effective rate was 96.74% in the observation group and 86.96% in the control group,and the difference was statistically significant( χ~2= 5.88,P<0.05). After treatment,the PSQI score were significantly decreased( t =25.16,15.60; P<0.01),and there was significant difference between the two groups( t =-8.11,P< 0.01). The total effective rate was 97.83% in the observation group and 88.04% in the control group( χ~2= 6.70,P<0.01). Conclusion: Patients with rheumatoid esophagitis are accompanied by varying degrees of anxiety and depression symptoms. And the adjuvant psychological symptomatic treatment can significantly improve the efficacy.
引文
[1]边海鹏,陈锡美.胃食管反流病中安慰剂反应率的Meta分析[J].医学临床研究,2012,29(11):2068-2070
[2]何小勤,李颖,史丽萍,等.抗抑郁焦虑药物辅助治疗胃食管反流病的临床研究[J].湖南师范大学学报(医学版),2015,12(5):17-19
[3]潘邦兴.氟哌噻吨美利曲辛联合埃索美拉唑、莫沙必利治疗难治性胃食管反流病的疗效观察[J].中国基层医药,2016,23(16):2508-2512
[4]李建华.从肝论治胃食管反流病[J].四川中医,2013,31(7):12-13
[5]潘红艳,向雪莲,吕尚泽,等.非糜烂性反流病与反流性食管炎症状特点的比较[J].中华内科杂志,2016,55(7):510-514
[6]方玉成.埃索美拉唑与奥美拉唑治疗反流性食管炎的比较[J].蚌埠医学院学报,2012,37(10):1203-1205
[7]李焱生.反流性食管炎的精神心理因素分析及中西医防治探讨[J].中国社会医学杂志,2013,30(3):196-197
[8]周茜,刘真.氟哌噻吨美利曲辛联合埃索美拉唑治疗非糜烂性胃食管反流病伴焦虑抑郁疗效观察[J].现代中西医结合杂志,2015,24(9):945-946
[9]霍贵云.黛力新辅助治疗伴抑郁焦虑反流性食管炎疗效观察[J].现代中西医结合杂志,2015,24(31):3506-3508
[10]张国玲.胃食管反流病患者的临床特征及其预后的影响因素分析[J].中国综合临床,2016,32(11):1009-1012
[11]杨凌玲,李继昌,罗欣,等.老年反流性食管炎患者的心理状态及药物疗效分析[J].国际精神病学杂志,2016,43(5):879-881
[12]杨芸峰,浦斌红,屠丽萍,等.反流性食管炎的临床治疗研究进展[J].西部中医药,2015,28(5):146-149
[13]袁耀宗.(中华医学会消化病学分会胃肠动力学组).胃食管反流病治疗共识意见(2007西安)[J].中华消化杂志,2007,27(10):689-690
[14]刘均平,戚燕云,魏红山,等.胃食管反流病合并焦虑及抑郁状态初步临床评估[J].胃肠病学和肝病学杂志,2017,26(2):161-163
[15]黄艳.胃食管反流病患者精神心理状态与临床疗效的相关性研究[J].中国医学前沿杂志(电子版),2016,8(8):60-63
[16]唐娜娜,周海云,张红杰.艾普拉唑治疗糜烂性反流性食管炎的疗效[J].江苏医药,2016,42(20):2270-2272
[17]陈霞.反流性食管炎患者反流相关症状和精神心理症状特征的研究[J].实用医院临床杂志,2015,12(5):226-228
[18]Boltin D,Boaz M,Aizic S,et al.Psychological distress is not associated with treatment failure in patients with gastroesophageal reflux disease[J].J Psychosom Res,2013,75(5):462-466
[19]邹义龙,刘尧蓓,陈苏宁.氟哌噻吨美利曲辛片辅助治疗难治性胃食管反流病的Meta分析[J].药物评价研究,2016,39(5):851-857
[20]徐杲,华娴,徐希,等.氟哌噻吨美利曲辛联合质子泵抑制剂对伴焦虑抑郁的非糜烂性胃食管反流病的临床疗效[J].医学研究杂志,2016,45(1):138-140+162
[21]李菁.胃食管反流病患者焦虑及抑郁水平与生活质量相关性研究[J].人民军医,2016,59(9):931-933
[22]刘均平,戚燕云,魏红山,等.胃食管反流病合并焦虑及抑郁状态初步临床评估[J].胃肠病学和肝病学杂志,2017,26(2):161-163
[2]何小勤,李颖,史丽萍,等.抗抑郁焦虑药物辅助治疗胃食管反流病的临床研究[J].湖南师范大学学报(医学版),2015,12(5):17-19
[3]潘邦兴.氟哌噻吨美利曲辛联合埃索美拉唑、莫沙必利治疗难治性胃食管反流病的疗效观察[J].中国基层医药,2016,23(16):2508-2512
[4]李建华.从肝论治胃食管反流病[J].四川中医,2013,31(7):12-13
[5]潘红艳,向雪莲,吕尚泽,等.非糜烂性反流病与反流性食管炎症状特点的比较[J].中华内科杂志,2016,55(7):510-514
[6]方玉成.埃索美拉唑与奥美拉唑治疗反流性食管炎的比较[J].蚌埠医学院学报,2012,37(10):1203-1205
[7]李焱生.反流性食管炎的精神心理因素分析及中西医防治探讨[J].中国社会医学杂志,2013,30(3):196-197
[8]周茜,刘真.氟哌噻吨美利曲辛联合埃索美拉唑治疗非糜烂性胃食管反流病伴焦虑抑郁疗效观察[J].现代中西医结合杂志,2015,24(9):945-946
[9]霍贵云.黛力新辅助治疗伴抑郁焦虑反流性食管炎疗效观察[J].现代中西医结合杂志,2015,24(31):3506-3508
[10]张国玲.胃食管反流病患者的临床特征及其预后的影响因素分析[J].中国综合临床,2016,32(11):1009-1012
[11]杨凌玲,李继昌,罗欣,等.老年反流性食管炎患者的心理状态及药物疗效分析[J].国际精神病学杂志,2016,43(5):879-881
[12]杨芸峰,浦斌红,屠丽萍,等.反流性食管炎的临床治疗研究进展[J].西部中医药,2015,28(5):146-149
[13]袁耀宗.(中华医学会消化病学分会胃肠动力学组).胃食管反流病治疗共识意见(2007西安)[J].中华消化杂志,2007,27(10):689-690
[14]刘均平,戚燕云,魏红山,等.胃食管反流病合并焦虑及抑郁状态初步临床评估[J].胃肠病学和肝病学杂志,2017,26(2):161-163
[15]黄艳.胃食管反流病患者精神心理状态与临床疗效的相关性研究[J].中国医学前沿杂志(电子版),2016,8(8):60-63
[16]唐娜娜,周海云,张红杰.艾普拉唑治疗糜烂性反流性食管炎的疗效[J].江苏医药,2016,42(20):2270-2272
[17]陈霞.反流性食管炎患者反流相关症状和精神心理症状特征的研究[J].实用医院临床杂志,2015,12(5):226-228
[18]Boltin D,Boaz M,Aizic S,et al.Psychological distress is not associated with treatment failure in patients with gastroesophageal reflux disease[J].J Psychosom Res,2013,75(5):462-466
[19]邹义龙,刘尧蓓,陈苏宁.氟哌噻吨美利曲辛片辅助治疗难治性胃食管反流病的Meta分析[J].药物评价研究,2016,39(5):851-857
[20]徐杲,华娴,徐希,等.氟哌噻吨美利曲辛联合质子泵抑制剂对伴焦虑抑郁的非糜烂性胃食管反流病的临床疗效[J].医学研究杂志,2016,45(1):138-140+162
[21]李菁.胃食管反流病患者焦虑及抑郁水平与生活质量相关性研究[J].人民军医,2016,59(9):931-933
[22]刘均平,戚燕云,魏红山,等.胃食管反流病合并焦虑及抑郁状态初步临床评估[J].胃肠病学和肝病学杂志,2017,26(2):161-163