氟哌噻吨美利曲辛结合法莫替丁治疗伴睡眠障碍胃食管反流病患者的临床观察及对血清5-HT、NE的影响  

Clinical observation of haloperidazone-melitracen combined with famotidine in the treatment of GERD with sleep disorder and its effect on serum 5-HT and NE

作　　者：冯福海 宋芳[1] 谭诗云[1] FENG Fu-hai;SONG Fang;TAN Shi-yun(Department of Gastroenterology,Renmin Hosptial of Wuhan University,Wuhan Hubei 430060,China)

机构地区：[1]武汉大学人民医院消化内科

出　　处：《临床和实验医学杂志》2019年第23期2530-2534,共5页Journal of Clinical and Experimental Medicine

基　　金：湖北省自然科学基金项目(编号:No.2011CDB298)

摘　　要：目的观察氟哌噻吨美利曲辛结合法莫替丁治疗伴睡眠障碍胃食管反流病(GERD)患者的临床疗效及对血清5-羟色胺(5-HT)、去甲肾上腺素(NE)水平的影响。方法前瞻性选取武汉大学人民医院于2017年4月至2019年2月接受治疗的76例伴睡眠障碍GERD患者作为研究对象,采取随机性数字表法分为对照组和研究组,各38例。两组患者均口服氟哌噻吨美利曲辛治疗;研究组患者同时给予氟哌噻吨美利曲辛片口服。比较两组患者的临床治疗效果、不良反应发生情况及治疗前后胃食管反流病问卷(GerdQ)症状评分、食管运动能力和匹兹堡睡眠量表(PSQI)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)变化情况,检测并比较两组患者治疗前后血清5-HT、NE水平变化情况。结果治疗8周后,研究组临床总有效率为89.47%,相比对照组的71.05%明显升高(P<0.05);两组患者治疗不良反应发生率比较无显著差异(15.79%vs.10.53%,P>0.05)。治疗前两组GerdQ、PSQI、HAMA、HAMD评分比较差异无统计学意义(P>0.05),治疗后两组上述评分较治疗前均明显减小,且研究组GerdQ、PSQI、HAMA、HAMD评分均显著低于对照组(P<0.05)。治疗后两组患者的下食管括约肌(LES)静息压、食管体部远端蠕动压力、湿咽成功率、传导速度较治疗前均明显升高,且治疗后研究组较对照组升高更明显(P<0.05)。治疗前两组患者血清5-HT、NE水平比较差异无统计学意义(P>0.05),治疗后两组血清5-HT、NE水平较治疗前均显著升高,且研究组治疗后血清5-HT、NE也显著高于对照组(P<0.05)。结论氟哌噻吨美利曲辛结合法莫替丁治疗伴睡眠障碍胃食管反流病相比单纯应用法莫替丁治疗疗效更显著,其不仅可有效增强食管体部运动能力,提高食管括约肌静息压和食管吞咽成功率,具有更强的抗反抗能力,而且其还能有效改善患者的睡眠障碍,提高血清5-HT、NE水平,缓解不良Objective To observe the clinical efficacy of haloperidazone and melitracen combined with famotidine in the treatment of gastroesophageal reflux disease(GERD)with sleep disorder and its effect on serum 5-HT and NE levels.Methods 76 GERD patients with sleep disorders were randomly divided into the control group and research group,38 cases in each group.Two groups of patients were treated with Flupentixol and melitracen orally.The study group was given Flupentixol and melitracen tablets orally.The clinical efficacy,adverse reactions,symptom scores of GerdQ and Pittsburgh Sleep Scale(PSQI),esophageal motor ability and Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)and serum 5-HT and NE levels before and after treatment were compared between the two groups.Results The total effective rate of the study group was 89.47%,which was significantly higher than the 71.05%of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(15.79%vs.10.53%,P>0.05).After treatment,the GerdQ,PSQI,HAMA and HAMD scores of the two groups decreased significantly compared with that before treatment.The GerdQ,PSQI,HAMA and HAMD scores of the study group were significantly lower than those of the control group(P<0.05).After treatment,resting pressure of lower esophageal sphincter(LES),peristaltic pressure of distal esophageal body,successful rate of wet pharynx and conduction velocity of the two groups were significantly increased.Compared with those before treatment,there were significant differences between the study group and the control group after treatment(P<0.05).Compared with before treatment,the serum 5-HT and NE levels in both groups increased significantly after treatment,and the levels in the study group increased significantly after treatment compared with the control group(P<0.05).Conclusion Dropethiazide combined with melitracen and famotidine is more effective than famotidine alone in the treatment of gastroesophageal reflux disease with sleep diso

关 键 词：胃食管反流病 睡眠障碍 氟哌噻吨 美利曲辛 法莫替丁 5-羟色胺 去甲肾上腺素 

分 类 号：R57[医药卫生—消化系统]