雷贝拉唑、伊托必利联合坦度螺酮治疗非糜烂性胃食管反流病合并焦虑抑郁临床观察  

Clinical Observation on Rabeprazole and Itopride Combined with Tandospirone in the Treatment of Non-erosive Reflux Disease Complicated with Anxiety and Depression

作　　者：王晓伟 李美荣 牛美娜 王海翠 朱双双 Wang Xiaowei;Li Meirong;Niu Meina;Wang Haicui;Zhu Shuangshuang(Department of Internal Medicine,Fourth People's Hospital of Langfang City/Affiliated Hospital of Chengde Medical University,Langfang 065700,Hebei,China)

机构地区：[1]廊坊市第四人民医院/承德医学院附属医院内科,河北廊坊065700

出　　处：《药物流行病学杂志》2020年第12期809-813,共5页Chinese Journal of Pharmacoepidemiology

基　　金：廊坊市科技局资助项目(编号:2019013117)。

摘　　要：目的:观察雷贝拉唑、伊托必利联合坦度螺酮治疗非糜烂性胃食管反流病(NERD)合并焦虑抑郁的临床疗效及安全性。方法:90例NERD合并焦虑抑郁患者随机分为对照组与观察组各45例。对照组接受雷贝拉唑钠肠溶胶囊及盐酸伊托必利胶囊治疗;观察组在此基础上加用枸橼酸坦度螺酮片治疗。治疗8周后观察两组临床疗效,比较两组患者治疗前后症状评分、24 h食管阻抗-pH监测结果和胃泌素(GAS)、胃动素(MOT)、胃蛋白酶原(PG)水平,以及汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、健康调查简表(SF-36)评分变化。对显效、有效病例随访6个月,记录复发情况。结果:观察组总有效率为88.89%,明显高于对照组的73.33%(P<0.05)。治疗后,两组患者的症状评分、反流性疾病诊断问卷(RDQ)总积分、DeMeester评分,酸反流次数、弱酸反流次数、无酸反流次数、反流≥5 min次数、最长反流时间,血清PGⅠ水平,以及HAMA评分、HAMD评分和抑郁、焦虑、抑郁并焦虑病例数均较治疗前明显降低(P<0.05),血清GAS、MOT水平及SF-36评分则较前升高(P<0.05);且观察组上述指标均明显优于对照组(P<0.05)。观察组复发率也显著低于对照组(P<0.05)。结论:雷贝拉唑、伊托必利联合坦度螺酮可明显改善NERD合并焦虑抑郁患者的躯体症状和精神症状,有效性和安全性较高,复发率低,具有一定的临床应用价值。Objective:To explore the efficacy and safety of rabeprazole and itopride combined with tandospirone in the treatment of non-erosive reflux disease(NERD)complicated with anxiety and depression.Methods:Ninety NERD patients with anxiety and depression were randomly divided into control group and observation group,with 45 cases in each group.The control group was treated with rabeprazole sodium enteric capsule and itopride hydrochloride capsule,the observation group was supplemented tandospirone citrate tablets on the basis of the control group.After 8 weeks treatment,the clinical effect,symptom scores,24 h esophageal impedance pH monitoring results,Gastrin(GAS),Motilin(MOT),pepsinogen(PG)levels,Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and the short form-36 health survey(SF-36)scores were compared between the two groups.The apparent and effective cases were followed up for 6 months,and the recurrence was recorded.Results:The total effective rate(88.89%)in the observation group was significantly higher than that in the control group(73.33%)(P<0.05).After treatment,the symptom scores,reflux disease diagnosis questionnaire(RDQ)total score,DeMeester score,the number of acid reflux,the number of weak acid reflux,the number of no acid reflux,the number of reflux≥5 min,maximum reflux time,PGⅠlevel,HAMA scores and HAMD scores and the cases of depression,anxiety,depression with anxiety in two groups were lower than before(P<0.05),GAS level,MOT level and SF-36 score higher than before(P<0.05).The above indexes in the observation group were significantly better than those in the control group(P<0.05).The recurrence rate of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:Rabeprazole and itopride in combination with tandospirone could significantly improve the physical and mental symptoms of NERD complicated with anxiety and depression,which is of high efficacy and safety,low recurrence rate,has a certain clinical application value.

关 键 词：非糜烂性胃食管反流病 焦虑抑郁 雷贝拉唑 伊托必利 坦度螺酮 

分 类 号：R571[医药卫生—消化系统]