摘要
目的探讨舒肝解郁胶囊联合常规治疗对难治性胃食管反流病(rGERD)患者的症状改善、心理精神及生活质量的影响。方法将66例伴心理精神障碍的rGERD患者和41例不伴心理精神障碍的rGERD患者随机各分为常规治疗组和联合治疗组。常规治疗组给予雷贝拉唑肠溶片、枸橼酸莫沙必利分散片治疗,联合治疗组在此基础上加用舒肝解郁胶囊,疗程均为8周。比较常规治疗组和联合治疗组治疗前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、反流性疾病问卷(RDQ)评分及健康调查简易量表(SF-36)评分,观察并比较各组疗效和不良反应发生情况。结果在伴心理精神障碍rGERD患者中,常规治疗组的治疗后SAS、SDS、RDQ、SF-36评分与治疗前相比差异均无统计学意义(均P>0.05),而联合治疗组的治疗后SAS、SDS、RDQ评分均低于治疗前和常规治疗组,SF-36评分均高于治疗前和常规治疗组,且总有效率高于常规治疗组(均P<0.05)。在不伴心理精神障碍rGERD患者中,常规治疗组及联合治疗组的治疗后SF-36评分与治疗前相比差异均无统计学意义(P>0.05),但RDQ评分均低于治疗前(P<0.05);两组之间治疗后的RDQ、SF-36评分以及总有效率差异均无统计学意义(均P>0.05)。伴或不伴心理精神障碍的rGERD患者常规治疗组与联合治疗组的不良反应发生率差异均无统计学意义(均P>0.05)。结论对于伴有焦虑、抑郁的rGERD患者,与单纯常规治疗相比,舒肝解郁胶囊联合常规治疗能更有效改善患者的症状及生活质量;但对于不伴有焦虑、抑郁的rGERD患者,预防性使用抗焦虑、抑郁药物可能并无益处。
Objective To investigate the efficacy of Shugan Jieyu Capsules combined with conventional therapy on symptom improvement,psycho-psychiatric condition and quality of life in patients with refractory gastroesophageal reflux disease(rGERD).Methods Sixty-six rGERD patients with psycho-psychiatric disorder or 41 rGERD patients without psycho-psychiatric disorder were randomly divided into conventional therapy group and combination therapy group.The conventional therapy group was given Rabeprazole Enteric-Coated Tablets and Mosapride Citrate Dispersible Tablets,based on which the combination therapy group received additional Shugan Jieyu Capsules,and the treatment lasted for 8 weeks in both groups.The Self-Rating Anxiety Scale(SAS) scores,the Self-Rating Depression Scale(SDS) scores,the Reflux Disease Questionnaire(RDQ) scores and the MOS 36-item short-form health survey(SF-36) scores before and after treatment were compared between the conventional therapy group and the combination therapy group,and the efficacy and incidence of adverse reactions of all groups were observed and compared.Results Among rGERD patients with psycho-psychiatric disorder,the post-treatment SAS,SDS,RDQ or SF-36 scores did not statistically differ from the pre-treatment scores in the conventional therapy group(all P >0.05),whereas the combination therapy group exhibited lower post-treatment SAS,SDS and RDQ scores and higher post-treatment SF-36 scores than the pre-treatment and the conventional therapy group,along with a higher total effective rate than the conventional therapy group(all P <0.05).Among rGERD patients without psycho-psychiatric disorder,the post-treatment SF-36 scores did not statistically differ from the pre-treatment scores in the conventional and combination therapy groups( P >0.05),however,the post-treatment RDQ scores were lower than the pre-treatment scores( P <0.05);after treatment,there were no statistically significant differences between the two groups in RDQ or SF-36 scores,or total effective rate(all P >0.05).No statistically significant difference was found in incidence rate of adverse reactions of rGERD patients with or without psycho-psychiatric disorder between the conventional therapy group and the combination therapy group(all P >0.05).Conclusion For patients with rGERD accompanied by anxiety or depression,compared with conventional therapy alone,Shugan Jieyu Capsules can improve patients′ symptom and quality of life more effectively in combination with conventional therapy;however,rGERD patients without anxiety/depression may not gain any benefits from prophylactic anti-anxiety/depression medication.
作者
陆明军
谭诗云
LU Ming-jun;TAN Shi-yun(Department of Gastroenterology,Minda Hospital of Hubei Minzu University,Enshi 445000,China;Department of Gastroenterology, Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《广西医学》
CAS
2019年第18期2301-2305,2325,共6页
Guangxi Medical Journal
关键词
难治性胃食管反流病
焦虑
抑郁
舒肝解郁胶囊
常规治疗
生活质量
症状改善
Refractory gastroesophageal reflux disease
Anxiety
Depression
Shugan Jieyu Capsules
Conventional therapy
Quality of life
Symptom improvement
