A Randomised, Controlled Clinical Trial On The Efficacy Of Antidepressive Therapy In The Treatment Of Elderly Patients With Non-erosive Gastroesophageal Reflux Disease

ObjectiveNon-erosive gastroesophageal reflux disease(NERD) is a global disease in theelderly.The cure rate is low,and the recurrence rate is high.It even seriously influencesthe quality of life of the patients,and often brings heavy psychological andeconomical burden to the patients and their families.To explore the efficacy ofantidepressive therapy in the treatment of elderly patients with NERD.Then we canget a further understanding of the relationship between mental factors and NERD inthe elderly patients,which also means that we should pay more attentions to theapplication of antidepressant treatment in the elderly patients with NERD.MethodsFrom the July2012to the July2013,we identified160elderIy patients,diagnosedwith NERD and associated with depressive disorders, Who were Our hospitaloutpatients and inpatients.Then they were randomly divided into anti-depressiongroup(n=80) and control group(n=80).Both the anti-depression group and the controlgroup received lansoprazole and Itopride for8weeks.Meanwhile the anti-depression group added psychological counseling and flupenthixol melitracen. Beforethe treatment and by the end of the8weeks,all the patients should be asked tocomplete the questionnaires of GerdQ and HAMD. The statistical data was analyzedby t-test and chi-square test.Value of P<0.05was considered to be significant. Results1.Before the treatment,the GerdQ scores of anti-depression group were（12.08±4.03）and by the end of the eight weeks were（6.34±3.13）.Before thetreatment,the GerdQ scores of control group were（12.12±4.02）and by the end of theeight weeks were（9.16±3.31）.By the end of the eight weeks,there was significantdiffierence of the GerdQ scores between the anti-depression group and the controlgroup (P<0.05).2.By the end of the eight weeks of the treatment,the total effective rate of theimprovement of non-erosive gastroesophageal reflux disease symptoms of controlgroup was45%（36/80）,and the anti-depression group was87.5%（70/80）.There wassignificant diffierence between the two groups（x2=32.313，P<0.01).3.Before the treatment,the HAMD scores of anti-depression group were(20.2±3.5），and by the end of the eight weeks were(7.9±2.7).Before the treatment,theHAMD scores of control group were(19.8±3.7)and by the end of the eight weekswere(16.3±3.4).By the end of the eight weeks,there was significant diffierencebetween the two groups(P<0.05).4.By the end of the eight weeks of the treatment,the total effective rate of theimprovement of depression of control group was20%（16/80）,and the anti-depressiongroup was70%（70/80）.There was significant diffierence between the two groups(x2=40.404，P<0.01).Conclusion1.The effect of the group of combination with psychological counseling plusantidepressant was superior to that of the usual-care group,the patients of whichrecived proton pump inhibitor and prokcinetic drug.2.It was the combined treatment of PPI,prokcinetic drug,psychologicalcounseling and antidepressant that can Significantly improve the mental and physicalsymptoms in elderly patients with NERD.3.The clinical trial shows that the NERD in the elderly patients is a kind ofillness, which is related to psychological factors. After a deeper understanding of the disease, the adjuvant therapy of some related drugs might can improve the efficacy ofantidepressant.