小剂量抗抑郁药与聚乙二醇4000联合治疗便秘型肠易激综合征  

Paroxetine and Polyethylene Glycol (PEG)4000 Therapy in Irritable Bowel Syndrome

作　　者：陈玉龙[1] 王霞[1] 尚杰[1] 

机构地区：[1]郑州大学第一附属医院消化内科,450052

出　　处：《中国心理卫生杂志》2004年第11期806-809,共4页Chinese Mental Health Journal

摘　　要：目的 :探讨小剂量抗抑郁药—盐酸帕罗西汀与聚乙二醇 (PEG) 40 0 0联合治疗便秘型肠易激综合征 (C -IBS)的疗效。方法 :按罗马标准Ⅱ选择 46例C -IBS患者随机分 2组 ,联合组 2 3例给于盐酸帕罗西汀 (10mgqd)加PEG40 0 0 (10gbid) ,对照组 2 3例给于盐酸帕罗西汀 (10mgqd) ,疗程为 8周 ,观察比较用药前后IBS症状评估 (腹胀、腹痛、排便困难、排便不尽、食欲不振 ) ,排便频率和Bristol大便性状 ,及情绪状态评分 (汉密尔顿抑郁 焦虑量表HAMD HAMA)。结果 :在治疗前后 2组患者IBS症状评分及HAMD HAMA评分均显著减低 (P <0 0 5 ) ,二组间比较无明显差异 (P >0 0 5 )。联合组在治疗的第 1周至第 4周排便频率和大便性状的改变与对照组有显著性差异 (P <0 0 5 ) ;HAMD HAMA评分在第 1周末、第 2周末、第 3周末下降较对照组明显 ,但无统计学差异意义 (P >0 0 5 )。从第四周至治疗结束 2组间各观察指标无显著性差异。结论 :PEG40 0 0与小剂量盐酸帕罗西汀联用能快速明显缓解胃肠道症状、改善焦虑抑郁情绪状态 ,是一种治疗C -IBS的有效方法 ,值得临床推广 ,其机理有待进一步研究。Object:To investigate the therapeutic effects of some-dose antidepressant:paroxetine hydrochloricde and Polyethylene glycol (PEG) 4000 in the treatment of constipation -predominant irritable bowel syndrome (C-IBS).Methods:An eight-week, randomized comparative study in 46 patients who met the RomeⅡcriteria for C-IBS. 23 patients in combined treatment group took PEG4000(10g bid) plus paroxetine hydrochloride(10mg bid). Efficacy was assessed by patients' perception of overall IBS symptoms .Bristol stool consistency and stool frequency. psychological status (analyzed with Hamilton Depression/Anxiety Scale,HAMD /HAMA). Results:The severity of patients' perception of overall IBS symptoms and constipation and psychological status were significantly lower in both group after 8-week treatment (P<0.05). During the earlier 4 weeks the weekly records of Bristol stool consistency and stool frequency were improved significantly compared with control group. HAMA/HAMD scores were lower on 1st weekend 2nd weekend but the difference had no statistic meaning .After week 4 onwards and lasting throughout the rest treatment period, there were no significant difference between 2 groups (P>0.05). Conclusion:The combination of PEG4000 and paroxetine hydrochloride can significantly relieving overall IBS symptoms, constipation and psychological status ,it is a more effective method in treating C-IBS .However a further study on its mechanisms is suggested.

关 键 词：治疗 盐酸帕罗西汀 小剂量 HAMA 便秘型肠易激综合征 HAMD 对照组 周末 结论 情绪状态 

分 类 号：R574[医药卫生—消化系统] R743[医药卫生—内科学]