| 王亚雷,王伟伟,许建明,等.埃索美拉唑联合氟哌噻吨美利曲辛治疗难治性胃食管反流病的多中心临床观察研究[J].安徽医药,2015,19(10):2009-2011. |
| 埃索美拉唑联合氟哌噻吨美利曲辛治疗难治性胃食管反流病的多中心临床观察研究 |
| A multi center trail of esomeprazole combined with flupenthixol melitracen in the treatment of refractory GERD patients |
| 投稿时间：2015-03-23 |
| DOI： |
| 中文关键词: 胃食管反流病 埃索美拉唑 氟哌噻吨美利曲辛 |
| 英文关键词: refractory gastroesophageal reflux disease proton pump inhibitor antidepressant |
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| 中文摘要: |
| 目的 采用埃索美拉唑联合氟哌噻吨美利曲辛对难治性胃食管反流病患者进行了多中心临床观察研究,以探讨联合治疗的有效性,并对患者的临床特点进行分析。方法 收集2012年7月—2013年6月5家医院消化内科门诊就诊的胃食管反流病患者,给予患者口服埃索美拉唑40 mg·d-1,治疗2周后,对患者的症状进行评估。以症状发作频率每周＜2次作为症状缓解的标准。症状缓解者,予埃索美拉唑20 mg·d-1继续治疗4周；症状未缓解者,予埃索美拉唑20 mg·d-1联合氟哌噻吨美利曲辛21 mg·d-1治疗4周。治疗开始前及结束后均行反流性疾病问卷、综合医院焦虑抑郁量表评分。结果 共收集189例胃食管反流病患者,经过埃索美拉唑40 mg·d-1治疗2周后,有70例患者症状得到完全缓解。119例症状未缓解的患者,予以埃索美拉唑联合氟哌噻吨美利曲辛治疗4周后,有92例(77.3%)症状达缓解标准,27例(22.7%)未达缓解标准。埃索美拉唑治疗无效患者的焦虑抑郁状态所占的比例及积分均显著高于埃索美拉唑治疗有效患者；联合治疗症状缓解和未缓解患者的焦虑抑郁状态治疗前差异无统计学意义；不论患者症状是否得到缓解,联合治疗后焦虑抑郁积分均较治疗前明显下降；在联合治疗有效的92例患者中,有24例患者在治疗前后均没有焦虑抑郁状态。结论 胃食管反流病患者的焦虑抑郁状态可能影响质子泵抑制剂的疗效,质子泵抑制剂联合氟哌噻吨美利曲辛可以有效缓解胃食管反流病患者的症状,改善胃食管反流病患者的焦虑抑郁状态。同时联合治疗对部分没有焦虑抑郁状态的患者也可起到缓解症状的作用。 |
| 英文摘要: |
| Objective To observe the effect of esomeprazole combined with flupenthixol melitracen in the treatment of GERD patients,especially those patients with refractory GERD.Methods 189 GERD patients were collected in multi centers of Anhui province from July 2012 to June 2013.The patients were treated with esomeprazole 40 mg·d-1 for 2 weeks.If the symptoms did not relieve,the patients were treated with esomeprazole 20mg·d-1 and flupenthixol melitracen 21 mg·d-1 for 4 weeks.RDQ and HADS were filled out again by GERD patients before and after the combined treatment.According to the Montreal definition,the symptom relief standard was defined as the frequency of symptoms during the last week of treatment being less than twice per week.Results After treatment with esomeprazole,the symptoms of 119(63.0%) GERD patients did not improve.Then treatment was carried out of the 119 patients with PPI and flupenthixol melitracen,the symptoms of 92(77.3%) patients improved.After treatment with PPI and flupenthixol melitracen,there were no differences in the proportion and integral of anxiety and depression between patients with symptoms improved and patients without symptoms improved (P＞0.05).Anxiety and depression integral significantly decreased after treatment with PPI and flupenthixol melitracen in GERD patients with or without symptoms improved(P＜0.05).Conclusions Treatment with PPI and flupenthixol melitracen can effectively relieve GERD symptoms,improve the state of anxiety and depression of the patients with refractory GERD. |
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