质子泵抑制剂联合抗抑郁药治疗咽喉反流性疾病的疗效分析  

Treatment of pat ients with laryngopharyngeal reflux disease by PPI combined with antidepressants management:A prospective randomized controlled trial

作　　者：刘蔓林 黄宁[1] 王刚[1] 王茂鑫[1] 杨帆[1] 陈贤明[1] LIU Manlin;HUANG Ning;WANG Gang;WANG Maoxin;YANG Fan;CHEN Xianming(Department of Otolaryngology Head and Neck Surgery,PLA 900 Hospital of the Joint Logistics Team,Fuzhou,Fujian,350025,China)

机构地区：[1]中国人民解放军联勤保障部队第九○○医院耳鼻咽喉头颈外科,福建福州350025

出　　处：《中国耳鼻咽喉头颈外科》2022年第12期795-798,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：福建省自然科学基金面上项目(2020J011143)。

摘　　要：目的评价质子泵抑制剂(proton pump inhibitor,PPI)联合使用抗抑郁药对咽喉反流性疾病(laryngopharyngeal reflux disease,LPRD)患者的疗效。方法收集2018年7月~2019年10月就诊于中国人民解放军联勤保障部队第九〇〇医院耳鼻咽喉头颈外科疑似LPRD合并抑郁症状患者62例,按随机数字表法分为研究组(单用艾司奥美拉唑治疗)和对照组(艾司奥美拉唑联合艾司西酞普兰治疗),所有患者随访8周后再次进行反流症状指数评分量表(reflux symptom index,RSI)、反流体征评分量表(reflux finding score,RFS)及Zung抑郁自评量表(self-rating depression scale,SDS)评分。研究组失访9例,最终纳入26例;对照组失访5例,最终纳入22例。结果治疗前组间RSI、RFS、SDS评分比较,差异无统计学意义(P>0.05);治疗后组间RSI、SDS评分比较,差异有统计学意义(P>0.05);治疗前RSI与SDS评分呈正性相关(r=0.529,P<0.01),RFS与SDS评分无相关性(r=0.170,P<0.126);治疗后研究组RSI与SDS评分呈正相关(r=0.354,P<0.05),而对照组无相关性(r=-0.021,P<0.884)。结论在LPRD合并抑郁状态的患者中,反流症状评分越重抑郁评分越高;针对LPRD合并抑郁症状的患者,联合使用抗抑郁药物较单纯使用抑酸药效果更佳。OBJECTIVE To evaluate whether proton pump inhibitor(PPI)combined with antidepressants are effective in treatment of patients with laryngopharyngeal reflux disease(LPRD)and depression.METHODS A total of 62 patients with suspected LPRD complicated with depressive symptoms admitted to the Department of Otolaryngology Head and Neck Surgery from July 2018 to October 2019 were collected.According to the random number table method,they were divided into the study group(esomeprazole alone)and the control group(esomeprazole combined with escitalopram).RSI,RFS and SDS scales were scored again after 8 weeks of follow-up.In the final study group,9 cases were lost to followup,and 26 cases were finally included in the experiment.The control group lost 5 cases to follow-up,and finally included 22 cases in the experiment.RESULTS Before treatment,there was no significant difference in RSI,RFS and SDS scores between groups(P>0.05).After treatment,RSI and SDS scores were significantly different between groups(P>0.05).Before treatment,there was positive correlation between RSI and SDS score(r=0.529,P<0.01),but no correlation between RFS and SDS score(r=0.170,P<0.05).After treatment,there was a positive correlation between RSI and SDS in the study group(r=0.354,P<0.05),but no correlation between RSI and SDS in the control group(r=-0.021,P<0.05).CONCLUSION In patients with LPRD and depressive symptoms,more severe the reflux symptoms,greater is the degree of depression.For patients with LPRD and depressive symptoms,the combination of a PPI and Antidepressants is more effective than PPI alone.

关 键 词：质子泵抑制剂 抗抑郁药 咽喉反流性疾病 

分 类 号：R766[医药卫生—耳鼻咽喉科]