地尔硫卓与氟西汀治疗食管远端痉挛的疗效比较:随机对照试验。

IF 1.1 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Mojgan Forootan , Mohsen Rajabnia , Ahmad Ghorbanpoor Rassekh , Saeed Abdi , Mobin Fathi , Mohamad Amin Pourhoseingholi , Pardis Ketabi Moghadam
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引用次数: 0

摘要

背景和研究目的:远端食管痉挛是一种不常见的食管运动障碍,表现为非心源性胸痛和吞咽困难。治疗的主要目标是通过药物、内窥镜和手术疗法缓解症状。药物治疗创伤较小,是首选方法。本研究旨在比较地尔硫卓与氟西汀治疗食管远端痉挛的疗效:共评估了 125 名通过内窥镜检查、食管钡餐造影和测压法确诊的食管远端痉挛患者。患者被分为地尔硫卓组和氟西汀组,分别接受为期两个月的地尔硫卓+奥美拉唑或氟西汀+奥美拉唑试验。在 125 名患者中,55 人失去了随访机会,70 人符合最终分析条件。临床症状和体征在治疗前后使用四种有效问卷进行评估:结果:两种疗法都能明显缓解症状(地尔硫卓组和氟西汀组的艾卡尔特评分平均值分别降低了 2.57 和 3.18;地尔硫卓组和氟西汀组的胃灼热评分平均值分别降低了 0.89 和 1.03)。根据短表-36,患者的生活质量有所改善(氟西汀组和地尔硫卓组的平均得分分别提高了 2.37 分和 3.95 分)。患者生活质量的改善与症状的严重程度没有关系。根据医院焦虑和抑郁量表得出的心理结果不一致(氟西汀组和地尔硫卓组的平均分分别降低了 0.143 和 0.57;P > 0.05):氟西汀和地尔硫卓能有效缓解食管远端痉挛患者的临床症状,但在改善心理症状方面效果不佳。两种治疗方案在疗效方面均不占优势。因此,在选择疗法时,关键是要考虑副作用和合并症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of the efficacy of diltiazem versus fluoxetine in the treatment of distal esophageal spasm: A randomized-controlled-trial

Background and study aim

Distal esophageal spasm is an uncommon esophageal motility disorder presenting with non-cardiac chest pain and dysphagia. The main goal of therapy is symptom relief with pharmacologic, endoscopic, and surgical therapies. Pharmacologic treatment is less invasive and is the preferred method of choice. The purpose of this study was to compare the effectiveness of diltiazem versus fluoxetine in the treatment of distal esophageal spasm.

Patients and methods

A total of 125 patients with distal esophageal spasm diagnosed using endoscopy, barium esophagogram, and manometry were evaluated. Patients were divided into diltiazem and fluoxetine groups and received a 2-month trial of diltiazem + omeprazole or fluoxetine + omeprazole, respectively. Of 125 patients, 55 were lost to follow up and 70 were eligible for final analysis. Clinical signs and symptoms were assessed before and after therapy using four validated questionnaires: Eckardt score, short form-36, heartburn score, and the hospital anxiety and depression scale.

Results

Both regimens significantly relieved symptoms (a decrease in mean Eckardt score of 2.57 and 3.18 for diltiazem and fluoxetine groups, respectively; and a decrease in mean heartburn score by 0.89 and 1.03 for diltiazem and fluoxetine groups, respectively). Patients’ quality of life improved based on short form-36 (an increase in mean score of 2.37 and 3.95 for fluoxetine and diltiazem groups, respectively). There was no relationship between patients’ improvement and severity of symptoms. Psychological findings based on the hospital anxiety and depression scale were inconsistent (a decrease in mean of 0.143 and 0.57 for fluoxetine and diltiazem groups, respectively; p > 0.05).

Conclusion

Fluoxetine and diltiazem were effective for clinical symptom relief in patients with distal esophageal spasm, but were not promising for improving psychological symptoms. Neither regimen was superior in terms of efficacy. Consequently, it is key to consider side effects and comorbidities when choosing a therapy.

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来源期刊
Arab Journal of Gastroenterology
Arab Journal of Gastroenterology Medicine-Gastroenterology
CiteScore
2.70
自引率
0.00%
发文量
52
期刊介绍: Arab Journal of Gastroenterology (AJG) publishes different studies related to the digestive system. It aims to be the foremost scientific peer reviewed journal encompassing diverse studies related to the digestive system and its disorders, and serving the Pan-Arab and wider community working on gastrointestinal disorders.
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