阿戈美拉汀联合富马酸伏诺拉生治疗难治性胃食管反流病的疗效分析  

Efficacy of agomelatine in combination with vonprazan fumarat for refractory gastroesophageal reflux disease

作　　者：侯永政 宋岩 刘响[2] 王瑄 苏帅[2] 陈鑫[2] 张毅宏[1] 王邦茂[2] 姜葵[2] HOU Yongzheng;SONG Yan;LIU Xiang;WANG Xuan;SU Shuai;CHEN Xin;ZHANG Yihong;WANG Bangmao;JIANG Kui(Department of Gastroenterology and Hepatology,Tianjin Beichen Hospital,Tianjin 300400,China;Department of Gastroenterology and Hepatology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津市北辰医院消化内科,300400 [2]天津医科大学总医院消化内科,300052

出　　处：《国际消化病杂志》2023年第1期23-27,共5页International Journal of Digestive Diseases

摘　　要：目的通过观察难治性胃食管反流病(rGERD)患者治疗前后精神心理及睡眠情况的变化,探讨阿戈美拉汀联合富马酸伏诺拉生治疗rGERD的效果。方法选择2021年3月至2021年10月于天津医科大学总医院就诊的54例rGERD患者,分为常规组(26例)和试验组(28例)。常规组给予富马酸伏诺拉生治疗,试验组在给予与常规组相同治疗的基础上,联合阿戈美拉汀治疗,疗程均为8周。采用胃食管反流病问卷(GERDQ)、抑郁症筛查量表(PHQ-9)、广泛性焦虑量表(GAD-7)及睡眠障碍评定量表(SDRS)对2组治疗前后的消化道症状、精神心理状态及睡眠情况进行比较,并采用治疗前后各项评分的差值比较2组的疗效。结果2组患者的性别构成、平均年龄、平均病程,以及治疗前GERDQ、PHQ-9、GAD-7、SDRS评分的差异均无统计学意义(P均>0.05)。治疗8周后,常规组治疗后GERDQ评分较治疗前下降[(6.58±0.26)分比(10.00±0.32)分],差异有统计学意义(P<0.05)。试验组的治疗后GERDQ、PHQ-9、GAD-7及SDRS评分均较治疗前显著下降[(6.64±0.19)分、(2.86±0.64)分、(1.64±0.54)分、(6.50±0.81)分比(10.93±0.41)分、(8.07±1.05)分、(5.57±0.93)分、(12.50±1.35)分],差异均有统计学意义(P均<0.05)。试验组治疗前后的GERDQ、PHQ-9、GAD-7及SDRS评分差值均显著大于常规组[(4.27±0.33)分、(5.21±0.57)分、(3.93±0.53)分、(6.70±3.72)分比(3.42±0.31)分、(1.62±0.30)分、(0.88±0.37)分、(1.46±0.47)分],差异均有统计学意义(P均<0.05)。2组患者治疗后均未发生不良反应。结论rGERD患者存在精神心理异常和睡眠障碍,阿戈美拉汀联合富马酸伏诺拉生治疗能显著改善rGERD患者的消化道症状,并能缓解睡眠障碍及抑郁、焦虑状态,联合用药的疗效优于单用富马酸伏诺拉生。Objective This paper intends to investigate the changes of mental and psychological status and sleep status of patients with refractory gastroesophageal reflux disease(rGERD)before and after treatment,and to explore the efficacy of agomelatine in combination with vorolaxen fumarate in the treatment of rGERD.Methods Fifty-four patients with rGERD who were treated in Tianjin Medical University General Hospital from March 2021 to October 2021 were assigned to the conventional group(26 cases)and the experimental group(28 cases).The conventional group was treated with vorolaxen fumarate,while the experimental group was treated in the same way as the conventional group but in combination with agomelatine.Both groups were treated for 8 weeks.Gastroesophageal reflux disease questionnaire(GERDQ),depression screening scale(PHQ-9),generalized anxiety scale(GAD-7),and sleep disorder rating scale(SDRS)were used to compare the digestive tract symptoms,mental and psychological status,and sleep status of the two groups before and after treatment,and the difference of each score before and after treatment was used to compare the efficacy of the two groups.Results There are no significant differences in gender composition,average age,average course of disease,and GERDQ,PHQ-9,GAD-7 and SDRS scores before treatment between the two groups(P>0.05).After 8 weeks of treatment,the GERDQ score of the conventional group decreased((6.58±0.26)points versus(10.00±0.32)points),with a statistically significant difference(P<0.05).The scores of GERDQ,PHQ-9,GAD-7,and SDRS in the experimental group after treatment are significantly decreased((6.64±0.19)points,(2.86±0.64)points,(1.64±0.54)points,(6.50±0.81)points versus(10.93±0.41)points,(8.07±1.05)points,(5.57±0.93)points,(12.50±1.35)points),with statistically significant differences(P<0.05).The differences in GERDQ,PHQ-9,GAD-7,and SDRS scores before and after treatment in the experimental group are significantly greater than that in the conventional group((4.27±0.33)points,(5.21±0.57)p

关 键 词：难治性胃食管反流病 抑郁 焦虑 睡眠障碍 阿戈美拉汀 疗效 

分 类 号：R571[医药卫生—消化系统]