匹维溴胺治疗老年人功能性肠道障碍的临床疗效及生活质量评估  

Evaluating the clinical effect and quality of life in the elderly with functional bowel disorder after treatment with pinaverium bromide

作　　者：季洪赞[1] 吴晓尉[1] 许小兵[1] 孙泉[1] 刘瑜[2] 张立[1] 赵文新[2] 于正洪[2] 张志良[2] 龚维忠[2] 郑雷[2] 

机构地区：[1]解放军南京军区南京总医院干部消化科 [2]解放军南京军区南京总医院老年病科,江苏省南京市210002

出　　处：《中国组织工程研究与临床康复》2007年第12期2275-2278,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：军队科技创新基金资助~~

摘　　要：目的:观察匹维溴胺治疗老年人肠易激综合征、功能性腹胀、功能性便秘、功能性腹泻的疗效和不良反应,评估匹维溴胺治疗后生活质量的变化。方法:①选择2004-08/2006-08应用匹维溴胺治疗的肠易激综合征、功能性腹胀、功能性便秘、功能性腹泻的老年功能性肠道障碍患者分别99,67,171,52例。均符合罗马Ⅱ功能性肠道障碍诊断标准,且对治疗方案知情同意。65～74岁120例、75～84岁213例、>85岁56例。给予老年患者口服匹维溴胺(法国苏威制药公司)治疗,50mg/次,3次/d,治疗2个月。②治疗后评估疗效,分为4级:极好,良好,一般,无效。治疗前及治疗2个月后采用健康状况调查问卷评估患者生活质量。共有9个维度和36个条目,即生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康、健康变化,每个条目含1～10条目,得分高表示健康状况好。③计量资料和计数资料差异比较分别采用t检验和χ2检验。结果:老年功能性肠道障碍患者389例均进入结果分析。①疗效:匹维溴胺治疗老年人功能性肠道障碍总有效率达93.6%。肠易激综合征组、功能性腹胀组、功能性便秘组、功能性腹泻组总有效率分别为91.9%,91.0%,90.4%,90.4%,各组相近(P>0.05)。>85岁肠道功能障碍患者治疗总有效率明显低于65～74岁和75～84岁者(χ2=18.57,23.31,P<0.01)。②生活质量:功能性腹胀组治疗前生理功能、总体健康、活力、情感职能等4个维度的生活质量评分与肠易激综合征组、功能性便秘组相近(P>0.05),功能性腹胀组治疗前生理功能、活力、情感职能3个维度评分与功能性腹泻组比较,差异不明显(P>0.05)。功能性腹胀组在生理功能、总体健康、活力、情感职能4个维度评明显高于功能性便秘组、肠易激综合征组(P<0.05～0.01),功能性腹胀组在生理功能、活力、情感职能3个维度评分明显高于功能AIM： TO observe the curative effect and side effect of oral pinaverium bromide on irritable bowel syndrome （IBS）, functional bloating, functional constipation and functional diarrhea in eldedy patients with functional bowel disorder （FBD）, and evaluate the improvement on quality of life （QOL） in FBD patients. METHODS： （1）The experiment was carried out between August 2004 and August 2006 in FBD elderly patients who were divided into four groups： C1 group （n =99） was diagnosed by IBS, C2 group （n =67） was diagnosed by functional bloating, C3 group （n =171） was diagnosed by functional constipation, and C4 group （n =52） was diagnosed by functional diarrhea. All the patients were diagnosed as FBD （category C） according to Rome Ⅱ classification for the functional gastrointestinal disorders, and they were informed of treatment scheme and then agreed to join the experiment. Meanwhile, the general groups were classified into three major domains for age： 120 cases of 65-74 years old; 213 cases of 75-84 years old; 56 cases of over 85 years old. All the subjects were treated with oral administration of pinaverium bromide, 50 mg once, three times daily, totally for 2 months.（2）The curative effect after oral medication was analyzed in 4 ranks： excellent, better, good and ineffective. The medical outcomes study 36-item short-form health survey （SF-36） questionnaire was billed for patients before treatment and 2 months after treatment, including 36 items of 9dimensions： physiologic function, physiologic function, body pain, total health, vitality, social function, emotional function, mental health and health change. Each item was consisted of 1-10 points, and the higher scores indicated the better health status.（3）Measurement data and numeration data were compared with t test and X 2 test, respectively. RESULTS： All 389 FBD patients entered the result analysis. （1）Curative effect： It was found obvious effect of all four groups, which were treated by oral pinav

关 键 词：匹维溴胺 功能性肠道障碍 老年人 生活质量 

分 类 号：R373.2[医药卫生—病原生物学]