氟西汀治疗32例难治性肠易激综合征近期疗效观察  

Recent Effect of Fluoxetine on Patients with Refractory Irritable Bowel Syndrome

作　　者：程正位[1] 熊建光[1] 刘启胜[1] 王柳青[1] 吴娟[1] 

机构地区：[1]咸宁学院附属第一医院消化内科,湖北咸宁437100

出　　处：《咸宁学院学报（医学版）》2009年第6期470-472,共3页Journal of Xianning Univarsity(medical Sciences)

摘　　要：目的观察氟西汀治疗难治性肠易激综合征(IBS)的近期疗效。方法按照罗马Ⅲ标准选择32例难治性腹泻型IBS患者,采用自身对照临床试验,给予氟西汀20mg/d,疗程12周,治疗过程中评定患者IBS主要症状评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分。结果治疗后患者消化道主要症状评分、HAMD评分、HAMA评分均明显降低,差异有统计学意义(P<0.05),各观察指标呈逐周下降,按意图治疗(ITT)和方案分析(PP),治愈率分别为50.0%和51.6%,总有效率为分别96.8%和100.0%。结论心理因素在IBS的发病中起重要作用,氟西汀可显著改善难治性IBS患者的胃肠道症状及精神状态。Objective To evaluate the recent efficacy of fluoxetine on the gastrointestinal and psychiatric symptoms in patients with refractory irritable bowel syndrome （IBS）. Methods 32 patients with diarrheapredominant IBS symptoms according to the Rome Ⅲ criteria were treated with fluoxetine 20mg Qd for 12 weeks. The efficacy was evaluated by IBS gastrointestinal symptoms, abnormal frequency or consistency of defecation Hamilton depression scale （HAMD） and Hamilton anxiety scale （llAMA）. Results 31 eases completed 12 weeks therapy, and the overall IBS symptoms, the Bristol stool consistency, stool frequency and abdominal pain were significantly relieved （ P 〈 0.05） ; there was obvious reduction for HAMD and HAMA and the difference was significant as compared to before treatment. The healing rate and total efficacy rate were 50.0% and 51.6% at intention-to-treat（ITT） analysis, and 96.8% and 100.0% at per-protocal（PP） analysis, respectively. Conclusion Psychological factors play an important role in the pathogenesis of IBS. Fluoxetine can significantly improve the psychiatric and gastrointestinal symptoms of refractory IBS patients.

关 键 词：肠易激综合征 抗抑郁药 氟西汀 

分 类 号：R574.6[医药卫生—消化系统]