Effects Of Deanxit Combined With Esomeprazole And Mosapride On Treatment Of Refractory Gastroesophageal

BackgroundBeing a type of common and chronic digestive system diseases, Gastroesophageal reflux disease (GERD) refers a series of symptom or complication ofhuman being’s body status caused by the reflux of gastric contents. Proton pumpinhibitors (PPI) are the most effective treatment manners for GERD. By using PPI,although most GERD patients’ symptoms can be released, there are still a partnumber of patients whose symptoms cannot be released effectively after4-8weektreatments. This phenomenon is called refractory gastroesophageal reflux disease(RGERD). Recently, people have found that the new treatment manner of combiningDeanxit (drug name: Flupentixol and Melitracen tablets; composition: Flupentixol0.5mg and Melitracen10mg per tablet) and traditional medicines can improve thecurative efficacy of RGERD. The manner is also proving to be a highly safety and isworthy of popularizing in clinic. ObjectiveTreatment the RGERD combined with Deanxit, Esomeprazole and Mosapride,then discuss the effective treatment by observing the total scores, curative rate, scoresof Emotional disorder scale,24h esophageal pH monitoring and esophagealmanometry of patients’ clinical symptoms such as heartburn, sour regurgitation,retrosternal pain and food regurgitation.MethodsSelect the hospital’s82clinic and hospitalized patients from January2009toOctober2013as subjects, including44males and38females with the age of average48±6.2and range from26to69. The diagnostic criteria of the patients are accordingwith the Montreal definition of GERD and the consensus of the treatment of GERDin Xin’an China,2007. The patients were divided into two groups randomly, with thesample size41in observation group (includes23males and18females whose age ofaverage47.2±6.2and range from26to66) and sample size41in matched group(includes21males and20females whose age of average48.7±6.5and range from28to69). All of the patients had conducted endoscopy,24h esophageal PH monitoringand esophageal manometry with informed consents. Moreover, there was nosignificant difference of the two groups (P>0.05) in age, gender, status of smokingand excessive drinking, body mass index (BMI), scoure of Demeester, loweresophageal sphincter pressure (LESP) and length of lower esophageal sphincter(LESL). In8weeks course of the contrast tests, patients in the matched group aretreated by Esomeprazole (20mg, bid, po) and Mosapride (5mg, tid, po) while patientsin the observation group are treated by appending Deanxit (1tablet, every morningand noon) to that of the matched group. The curative effects of the two groups werereflected by GERD total scores, and the psychological states of the two groups weremeasured by self-rating anxiety scale (SAS) and self-rating depresses scale (SDS).Furthermore, the results of24h esophageal PH monitoring and esophagealmanometry were also contrasted. ResultsAfter8weeks’ treatments, by using the gastro esophageal reflux diseasequestionnaire (RDQ),34patients in the observation group had taken an obviouslybetter changing (RDQ score<12) contrast that of22samples in the matched group.And the effects different between the two groups is significant (P<0.05). Furthermore,the markedly improved sample size was14(34.15%), the improved sample size is21(51%) and the total effective rate was85.37%of the observation group, with thecontrast of that of the matched group were8(19.51%),17(41.46%),60.97%. And thetotal effective rate of the observation group is significant higher than that of thematched group (P<0.05). The differents of SDS and SAS index between the twogroups are not significant (P>0.05). After8weeks treating, the SDS and SAS indexwithin the two groups were significant decreased (P<0.05), which indicate the statesof anxiety and depress have been improved. For the observation group, SDS indexdecreased form55.3±8.8to42.1±9.1, while SAS index decreased from54.3±8.7to1.2±9.2; For the matched group, SDS index decreased form55.8±9.1to52.6±9.3,while SAS index decreased from53.0±8.9to49.3±9.1. Moreover, the differentbetween the two groups is also significant (P<0.05) which indicates that theimproving of the observation group was better than the matched group. In addition,after8weeks’ treatment, the within differences of the two groups are significantdecreased in the Demeester scoure. For the observation group, the Demeester scouredecreased form29.5±5.6to12.1±3.1; For the matched group, the Demeester scouredecreased form30.3±6.1to13.3±3.6. But the betweem and within differences ofthe two groups are not significant in LESP and LESL (P>0.05).ConclusionsThe treatment effect of RGERD could be improved by combining Deanxit，esomeprazole and mosapride. Moreover, the psychological factor is probably animportant influence of the nosogenesis of RGERD.