| Objective:By the method of questionnaire, high-resolution manometry on esophagus,24-hour esophageal pH monitoring and anti-reflux treatment on the chronic cougher on Gastroesophageal reflux diseases clinic, to study the main pathogenesis of GERC and phychological factors on it. To observe the the effects of antianxietics and antidepressants on GERC patients, providing theoretical foundation for the use of antianxietics and antidepressants on this kind of patients and improving the treatment level of GERC.Methods:1、To select chronic coughers on Gastroesophageal reflux diseases clinic with their approval,while healthy people as control group. All filled out questionnaire in general, Gastroesophageal Reflux Disease Questionnaire, reflux symptom score, Self-rating Anxiety Scale, Self-rating Depression Scale, Leicester Cough Questionnaire and cough symptom score.2、All subjects were teated by high-resolution manometry on esophagus and24-hour esophageal pH monitoring, to remove patients with DeMeester score<14.70.3、Patients with anxiety and depression were divided into2groups (group A and group B) randomly, while patients without anxiety and depression as group C. Patients in group B and C got only conventional anti-reflux treatment (Esomeprazole20mg twice/day and Magnesium Enteric-coated Tablets5mg twice/day); patients in group A got conventional anti-reflux treatment and antidepression treatment (Deanxit1pill on the morning and1pill on the noon). All got a12-week Course.4、All patients filled out GERD-Q, reflux symptom score, SAS, SDS, LCQ and cough symptom score in the4th week,8th week and12th week.5、After the12-week course, to analyze the effects by cough symptom score and to diagnose responsers with GERC. To choose GERC patients out from all3groups and divided them into group GERC A, group GERC B and group GERC C.6、By contrasting with the control group, to analyze the parameters of high-resolution manometry on esophagus and24-hour esophageal pH monitoring score of GREC patients, probing the pathogenesis of GERC. 7、Analyzing the anxiety and depression index and clinic symptom, the parameters of high-resolution manometry on esophagus and24-hour esophageal pH monitoring score of patients in all3groups, to study the effect of phychological factors on GERC.8、Comparing the result of GERD-Q, reflux symptom score, SAS, SDS, LCQ and cough symptom score of patients in different groups in different times, to analyze the effect of anti-depression treatment combined with conventional anti-reflux treatment.Result:1、The GERC patients’high-resolution manometry parameter on esophagus were all lower than the healthy control group, with24-hour esophageal pH monitoring parameter all higher than the healthy control group (P<0.01).2、The6kind of parameters and SAP of bottom electrode of24-hour esophageal pH monitoring of GERC patients were higher than parameters and SAP of top electrode.(P<0.01).3、The daytime cough rating if GERC patients were higher than night cough rating (P<0.01).4、52out of73GERC patients had symptom of anxiety and depression (71.2%).5、Compared with patients in group GERC C, the high-resolution manometry on esophagus parameters of patients in group GERC A and B were not significant different (P>0.05). Compared with patients in group GERC C, the high-resolution manometry on esophagus parameters of GERC patients with moderate and serious anxiety and depression were all lower (P<0.01).6、The frequency of top electrode reflux, the top electrode stand pH value and the frequency of bottom electrode reflux time>5min of group GERC A and B patients were all higher than group GERC C patients (P<0.01or P<0.05).The frequency of bottom electrode time>5min, the top and bottom electrode longest reflux time, the up and bottom total pH value, the top electrode stand pH value, the top and bottom decubitus pH value of moderate and serious anxiety and depression GERC patients were all higher than group GERC C patients (P<0.01or P<0.05).7、The SAS and SDS rating of GERC patients had positive correlation with their cough symptom, GERD, and reflux symptom rating, while having negative correlation with their LCQ scale rating.8、In or after the course, all patient in different groups got a decline in their GERD-Q, reflux symptom and cough symptom rating (P<0.01or P<0.05), and got a increase in their LCQ scale(P<0.05).9、In all time of the course, comparing their GERD-Q, reflux symptom score, LCQ scale and cough symptom score in the course with rating before the course, patients in group GERC A got a more significant difference than patients in group GERC B (P<0.05). Comparing the rating in4th week and12th week with original rating, patients in group GERC B got a more significant difference than patients in group GERC C (P<0.05).10、The SAS and SDS scale rating of group GERC A and group GERC B got a decline n and after the course. Comparing the rating before and after the course, Group GERC A had less difference than group GERC B (P值<0.001)Conclusion:1、Compared with the healthy control group,the esophageal LES resting pressure and esophageal mobility function of GERC patients were in worse condition,and their reflux symptom got worse.2、The reflux of GERC patients were mostly esophagus bottom electrode reflux, while few patient with top electrode reflux. Symptom in stand positon were more obvious than that in lying positon.3、Most of cough symptom of GERC patients were cough in daytime.4、GERC patients had a higher proportion (71.2%) of anxiety and depression than normal people and GERD patients;64.3%of them had moderate or serious anxiety.5、Compared with GERC patients without anxiety and depression symptom, the GERC patients with moderate or serious anxiety had higher esophageal LES resting pressure, decrease of esophageal mobility function, and more serious reflux.6、The rating in psychological conditions of GERC patients were in correlativity with their cough symptom and reflux conditions.7、When patients in group GERC A got Deanxit treatment combined with conventional anti-reflux treatment, their reflux, anxiety and cough symptom got more obvious improvement than patients in group GERC B, almost the same as effects of patients in group GERC C, with no obvious side effect. Objective:By the method of questionnaire, high-resolution manometry on esophagus,24-hour esophageal pH monitoring and anti-reflux treatment on the chronic cougher on Gastroesophageal reflux diseases clinic, to study the main pathogenesis of GERC and phychological factors on it. To observe the the effects of antianxietics and antidepressants on GERC patients, providing theoretical foundation for the use of antianxietics and antidepressants on this kind of patients and improving the treatment level of GERC.Methods:1、To select chronic coughers on Gastroesophageal reflux diseases clinic with their approval,while healthy people as control group. All filled out questionnaire in general, Gastroesophageal Reflux Disease Questionnaire, reflux symptom score, Self-rating Anxiety Scale, Self-rating Depression Scale, Leicester Cough Questionnaire and cough symptom score.2、All subjects were teated by high-resolution manometry on esophagus and24-hour esophageal pH monitoring, to remove patients with DeMeester score<14.70.3、Patients with anxiety and depression were divided into2groups (group A and group B) randomly, while patients without anxiety and depression as group C. Patients in group B and C got only conventional anti-reflux treatment (Esomeprazole20mg twice/day and Magnesium Enteric-coated Tablets5mg twice/day); patients in group A got conventional anti-reflux treatment and antidepression treatment (Deanxit1pill on the morning and1pill on the noon). All got a12-week Course.4、All patients filled out GERD-Q, reflux symptom score, SAS, SDS, LCQ and cough symptom score in the4th week,8th week and12th week.5、After the12-week course, to analyze the effects by cough symptom score and to diagnose responsers with GERC. To choose GERC patients out from all3groups and divided them into group GERC A, group GERC B and group GERC C.6、By contrasting with the control group, to analyze the parameters of high-resolution manometry on esophagus and24-hour esophageal pH monitoring score of GREC patients, probing the pathogenesis of GERC. Objective:By the method of questionnaire, high-resolution manometry on esophagus,24-hour esophageal pH monitoring and anti-reflux treatment on the chronic cougher on Gastroesophageal reflux diseases clinic, to study the main pathogenesis of GERC and phychological factors on it. To observe the the effects of antianxietics and antidepressants on GERC patients, providing theoretical foundation for the use of antianxietics and antidepressants on this kind of patients and improving the treatment level of GERC.Methods:1、To select chronic coughers on Gastroesophageal reflux diseases clinic with their approval,while healthy people as control group. All filled out questionnaire in general, Gastroesophageal Reflux Disease Questionnaire, reflux symptom score, Self-rating Anxiety Scale, Self-rating Depression Scale, Leicester Cough Questionnaire and cough symptom score.2、All subjects were teated by high-resolution manometry on esophagus and24-hour esophageal pH monitoring, to remove patients with DeMeester score<14.70.3、Patients with anxiety and depression were divided into2groups (group A and group B) randomly, while patients without anxiety and depression as group C. Patients in group B and C got only conventional anti-reflux treatment (Esomeprazole20mg twice/day and Magnesium Enteric-coated Tablets5mg twice/day); patients in group A got conventional anti-reflux treatment and antidepression treatment (Deanxit1pill on the morning and1pill on the noon). All got a12-week Course.4、All patients filled out GERD-Q, reflux symptom score, SAS, SDS, LCQ and cough symptom score in the4th week,8th week and12th week.5、After the12-week course, to analyze the effects by cough symptom score and to diagnose responsers with GERC. To choose GERC patients out from all3groups and divided them into group GERC A, group GERC B and group GERC C.6、By contrasting with the control group, to analyze the parameters of high-resolution manometry on esophagus and24-hour esophageal pH monitoring score of GREC patients, probing the pathogenesis of GERC. |
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