本文選題：非糜爛性胃食管反流病　切入點(diǎn)：胃食管反流病量表　出處：《華中科技大學(xué)》2014年博士論文　論文類型：學(xué)位論文

【摘要】：第一部分氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑?qū)Π橛薪箲]及抑郁狀態(tài)的NERD患者胃食管反流癥狀的療效 目的：通過氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑治療伴有焦慮及抑郁狀態(tài)NERD患者,觀察抗焦慮抑郁藥物對NERD患者反流癥狀的療效,探討氟哌噻噸美利曲辛片對伴有抑郁及焦慮狀態(tài)NERD患者的療效。 方法：84例伴有焦慮及抑郁狀態(tài)NERD患者隨機(jī)分為兩組,對照組(埃索美拉唑組)40例,治療組(氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑組)44例。對照組給予埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服,治療組給予氟哌噻噸美利曲辛片10mg,每日早午餐后口服,同時(shí)服用埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服。療程8周,并于治療前及治療后1、2、4、8周給予胃食管反流病量表(Gastroesophageal Reflux Disease Questionnaire,GERDQ)評分。 結(jié)果：1.治療前治療組與對照組GERDQ評分無統(tǒng)計(jì)學(xué)差異(P0.05)； 2.治療后1,2,4,8周,治療組GERDQ評分明顯低于對照組(P0.05),兩組GERDQ評分在治療一周后均呈下降趨勢,治療組GERDQ評分達(dá)到正常,對照組仍高于正常水平； 3.兩組GERDQ評分在治療后2,4,8周時(shí)仍維持在治療后1周水平,各組間相比無統(tǒng)計(jì)學(xué)差異(P0.05)； 4.治療組生活質(zhì)量評分在治療前與治療后有統(tǒng)計(jì)學(xué)差異(P0.05),對照組生活質(zhì)量評分在治療前與治療后無統(tǒng)計(jì)學(xué)差異(P0.05) 結(jié)論：氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑較單純使用埃索美拉唑治療對伴有抑郁及焦慮狀態(tài)的NERD患者更為有效,可明顯改善NERD患者的燒心,反酸等反流癥狀, 目的：通過氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑治療伴有焦慮及抑郁狀態(tài)NERD患者,觀察抗焦慮抑郁藥物對NERD患者HAD, HAM-D及HAM-A評分改善情況,探討氟哌噻噸美利曲辛片對伴有抑郁及焦慮狀態(tài)NERD患者焦慮抑郁狀態(tài)的影響。 方法：84例伴有焦慮及抑郁狀態(tài)NERD患者隨機(jī)分為兩組,對照組(埃索美拉唑組)40例,治療組(氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑組)44例。對照組給予埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服,治療組給予氟哌噻噸美利曲辛片10mg,每日早午餐后口服,同時(shí)服用埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服。療程8周,并于治療前及治療后1、2、4、8周給予綜合醫(yī)院焦慮/抑郁量表(Hospital Anxiety and Depression, HAD),漢密爾頓焦慮量表(Hamilton Anxiety rating scale, HAMA),漢密爾頓抑郁量表(Hamilton Depression rating scale, HAMD)評分。 結(jié)果：治療前治療組與對照組HAD, HAM-D及HAM-A評分均無統(tǒng)計(jì)學(xué)差異(P0.05),治療后1,2,4,8周,治療組HAD, HAM-D及HAM-A評分明顯低于對照組(P0.05),兩組HAD, HAM-D及HAM-A評分均呈下降趨勢,治療組下降較明顯,治療組HAD, HAM-D及HAM-A評分治療前與治療后8周相比均有統(tǒng)計(jì)學(xué)差異(P0.05),對照組HAM-D及HAM-A評分治療前與治療后8周相比均有統(tǒng)計(jì)學(xué)差異(P0.05), HAD評分治療前與治療后8周相比無統(tǒng)計(jì)學(xué)差異(P0.05)。 結(jié)論：氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑較單獨(dú)使用埃索美拉唑?qū)Π橛幸钟艏敖箲]狀態(tài)的NERD患者更為有效,并可明顯降低NERD患者的各項(xiàng)心理評分,他評量表HAM-D, HAM-A較自評量表HAD在NERD伴隨抑郁焦慮狀態(tài)的心理測評上更為敏感。 目的：通過氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑治療伴有焦慮及抑郁狀態(tài)NERD患者,觀察抗焦慮抑郁藥物對NERD患者HAM-D評分中各因子的影響,探討氟哌噻噸美利曲辛片對伴有抑郁及焦慮狀態(tài)NERD狀態(tài)作用。 方法：84例伴有焦慮及抑郁狀態(tài)NERD患者隨機(jī)分為兩組,對照組(埃索美拉唑組)40例,治療組(氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑組)44例。對照組給予埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服,治療組給予氟哌噻噸美利曲辛片10mg,每日早午餐后口服,同時(shí)服用埃索美拉唑鎂腸溶片20mg,每天早晚餐前20分鐘口服。療程8周,并于治療前及治療后1、2、4、8周給予漢密爾頓抑郁量表評分。 結(jié)果：治療前兩組HAM-D各因子評分均無統(tǒng)計(jì)學(xué)差異(P0.05),治療8周后,兩組體重,日夜變化,絕望感因子評分無統(tǒng)計(jì)學(xué)差異(P0.05),治療組焦慮/軀體化,認(rèn)知障礙,遲緩,睡眠障礙等評分較對照組明顯減(P0.05) 結(jié)論：氟哌噻噸美利曲辛片聯(lián)合埃索美拉唑?qū)Π橛幸钟艏敖箲]狀態(tài)的NERD患者較單純應(yīng)用埃索美拉唑更為有效,并可明顯改善NERD患者焦慮/軀體化,認(rèn)知障礙,遲緩,睡眠障礙等精神癥狀,顯著改善患者的生活質(zhì)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.

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2014
【分類號】：R57;R749

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