本文選題：抗焦慮抑郁 + 難治性反流性食管炎　； 參考：《重慶醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討抗焦慮抑郁藥物（氟哌噻噸美利曲辛）聯(lián)合質(zhì)子泵抑制劑（PPI）治療伴有焦慮和/或抑郁的難治性反流性食管炎(RRE)患者的臨床療效。 方法：將123例RRE伴焦慮和/或抑郁狀態(tài)的患者隨機分為兩組，均給予埃索美拉唑鎂腸溶片40mg，qd，雙盲給藥，1組服用1號藥物1片，bid，2組服用2號藥物1片，bid，療程4w結(jié)束后，1號藥物揭底顯示為氟哌噻噸美利曲辛，1組為試驗組（65例），2號藥物為安慰劑，2組為對照組（58例），治療過程中運用反流性疾病問卷量表（RDQ）、醫(yī)院焦慮抑郁量表（HADS）及胃鏡檢查，分別評估兩組治療前后臨床癥狀、焦慮抑郁狀況及胃鏡下分級變化情況，，密切觀察患者臨床癥狀及焦慮和/或抑郁狀態(tài)的變化情況、及時處理治療過程中出現(xiàn)的不良反應。 結(jié)果：治療4w后，試驗組的RDQ分值較對照組顯著降低，試驗組中：23例（35.38%）不適癥狀幾乎完全緩解，療效顯著；30例（46.15%）患者治療后癥狀分值較前明顯降低，治療有效，僅12例（18.46%）患者未見明顯療效，其有效率為81.53%。對照組的分值下降程度無明顯改善，僅6例癥狀分值較前有所下降，大多數(shù)（81.54%）患者未見明顯療效，其有效率為10.34%，試驗組有效率遠高于對照組，兩組差異有統(tǒng)計學意義（P＜0.01）。試驗組焦慮(t=-10.69)、抑郁(t=-12.57)情況較對照組改善明顯，兩組差異有統(tǒng)計學意義（P＜0.05）。試驗組和對照組在胃鏡下分級無統(tǒng)計學差異（P＞0.05）。試驗組6例患者輕度口干和便秘，尚無患者出現(xiàn)視物模糊等其他特殊不適；經(jīng)過1-2周適應期，患者口干癥狀自行消失，僅2例患者的便秘需要加用緩瀉劑，經(jīng)積極處理后完全緩解，對照組無明顯的不良反應。 結(jié)論：氟哌噻噸美利曲辛聯(lián)合PPI治療伴有焦慮抑郁的RRE患者短期療效顯著，可明顯改善患者臨床癥狀及焦慮、抑郁狀態(tài)，且無嚴重不良反應，值得在臨床工作中推廣應用。
[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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R571

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