The Treatment Value And Clinical Studies Of Combination Therapy For Patients With Functional Dyspepsia And Anxiety Disorders

Objective:Functional dyspepsia (FD) is one of the clinically common digestive disease, with high morbidity and recurrence rate, seriously affecting the daily work and life of the patient. Due to the complex risk factors, after conventional medical treatment, often fail to get the desired effect. This study by observing and comparing conventional medical treatment and joint anti-depressant, the combination therapy of anxiety and psychological intervention, select the relevant research indicators to evaluate the clinical efficacy and safety, in order to improve the quality of treatment of functional dyspepsia patients looking for more therapeutic approach provide a reference.Clinical data and methods:1EthicsAnxiety in this study used self-rating scale, self-rating depression scale research methods, have the patient’s consent before the study informed consent and approval of the Ethics Committee of Zhejiang University School of Medicine. The contents of the study and no adverse effects on the patient.2Case SourceSelect from March2012to March2014by the Second Affiliated Hospital, Zhejiang University School of Medicine, Department of Gastroenterology, functional dyspepsia patients admitted to the study. Gastroenterology Rome Ⅲ criteria adopted to develop patient enrollment inclusion and exclusion criteria, select qualified functional dyspepsia with depression, anxiety,62patients; research process in strict accordance with exclusion, removed, shedding and suspension test standards; press the number forms were randomly divided into observation group and control group31cases. Observation group compared with the control group baseline data:gender situation Upon examination,χ2=0.272, P=0.602>0.05; age distribution by test, t=-0.280, P=0.780>0.05and the duration of the case by the test,t==-0.583, P=0.562>0.05.3Research Methods3.1TreatmentThe control group using conventional digestive medicines, omeprazole (Zhunzi H10940188, Xi’an Lijun Pharmaceutical Co., Ltd.)20mg, orally,1time/day, Mosapride (Zhunzi H20051719, Shanghai Xinyi pharmaceutical Co., Ltd.)5mg, orally,3times/day, for taking four to five weeks. Observation Group:On the basis of conventional medical therapy combined with antidepressant drugs on psychological intervention such as a comprehensive treatment:1) antidepressant treatment:amitriptyline hydrochloride (Zhunzi H32020455, Changzhou four drug Pharmaceutical Co., Ltd.)25mg, orally,2times/day for oral7d, adjust the amount depending on the patient’s medication. 2) psychological intervention①medical staff patiently explain to patients the etiology of functional dyspepsia, treatment, clinical efficacy and effect of influencing factors, and actively look for reasons different from patients with negative emotions, and encourage patients to improve the treatment of self-confidence and treatment compliance;②guide patients develop proper eating habits;③using progressive muscle relaxation, guided imagination, group therapy and cognitive, music therapy;④asked the patient to actively participate in physical exercise or sports, to spread the patient’s attention;⑤use of individualized psychological intervention. Mental disorders according to the actual situation, seeking to meet the patient’s individual psychological barriers solutions, the implementation of a full range of targeted psychological interventions.3.2Observation methods3.2.1Efficacy Indicators1) Bad mood rating:Anxiety Rating Scale (self-rating anxiety scale, SAS) and Self-Rating Depression Scale (self-rating depression scale, SDS) for evaluation. Anxiety:SAS score>50points, depressive state:SDS score>50points.2) Depression, anxiety classification:SDS grading standards, mild:50-59points, moderate:60-69points, severe:>70points; ASA classification standard, mild:50-59points, moderate:60-69points, severe>70.3) Functional dyspepsia symptom scores:According to the upper abdominal pain, nausea, severe degree of fullness, heartburn, nausea and other symptoms were given a score:①asymptomatic0;②mild symptoms of a point;③moderate symptoms (consciously feel symptoms)2points;④ severe symptoms (obviously affect the normal work and life) three points. Accumulate each symptom score as functional dyspepsia symptom scores.3.2.2The evaluation indexTreatment efficiency=(total number of cases-invalid)/total number of cases x100.00%.1) markedly:complete remission of clinical symptoms;2) effective:clinical symptoms significantly alleviated;3) General:clinical symptoms improved slightly a little, little effect on the life and work;4) invalid:no significant changes in clinical symptoms or worse, seriously affecting their daily work and life.3.3Statistical MethodsWere analyzed using statistical software SPSS13.0processing, count data expressed as a percentage and χ2test, measurement data using mean±standard deviation (±s) said pairwise comparison using the t test, the test results are P<0.05indicates differences statistically significant.Results:1、A clinical efficacy of the two groups after treatment comparison:the observation group were cured11cases (35.48%),4cases, the treatment effective rate87.10%, the control group that were8cases (25.81%), ineffective in13cases, the treatment efficiency of58.06%, X2=5.187, P=0.023<0.05。2、Two groups of patients after treatment SDS, SAS, FD symptom score:SAS Rating:observation group43.44±9.32.The control group,50.10±9.36, t=2.807, P=0.007<0.05; SDS Rating:observation group44.46±7.36, control group52.02±8.20,t=3.820, P=0.000<0.05; FD symptom score: observation group4.76±3.02, in the control group8.21±4.32,t=3.644, P=0.001<0.05.3、The adverse reactions of two groups of cases:Adverse reaction incidence of three observation group and the control group, the difference was not statistically significant (P>0.05).Conclusions:1、Functional dyspepsia patients with depression, anxiety and other negative emotions or psychological disorders;2、Functional dyspepsia pros and cons of treatment with depression, anxiety and other negative emotions existence of relations Close;3、Psychological intervention can improve functional dyspepsia, depression, anxiety symptoms, eliminate the psychological barriers;4、A comprehensive psychological intervention therapy and antidepressant medication treatment of the digestive system regular basis, can Significantly improve the clinical efficacy and quality of life in patients with FD, safe and reliable.