文拉法辛联合马来酸曲美布汀及双歧三联活菌治疗难治性肠易激综合征的疗效观察  

Therapeutic Effect of Venlafaxine and Trimebutine and Bifidobiogen on Refractory Irritable Bowel Syndrome

作　　者：陈叶青[1] 周国华[1] 周红宇[1] 王为[1] 刘树旗[1] 王丽姣[1] 

机构地区：[1]中国人民解放军169医院消化内科,湖南省衡阳市421002

出　　处：《中国全科医学》2011年第5期547-549,共3页Chinese General Practice

摘　　要：目的探讨抗抑郁药文拉法辛联合马来酸曲美布汀及双歧三联活菌治疗难治性肠易激综合征(IBS)的疗效。方法选取80例经常规治疗无效的难治性IBS患者,按治疗方法分为两组:观察组和对照组,各40例。对照组给予常规胃肠药物治疗(马来酸曲美布汀、双歧三联活菌胶囊),观察组在常规胃肠药物治疗的基础上加服抗抑郁药文拉法辛缓释片,75 mg/d,晚间顿服,同时配合支持性心理治疗,疗程为12周。治疗前后比较患者的临床消化道症状(以症状程度指数和症状频率指数表示)、精神量表〔汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HA-MA)〕评分及疗效。结果 (1)消化道症状:治疗后观察组患者的症状程度指数和症状频率指数均显著低于对照组,差异有统计学意义(P<0.05)。(2)观察组显效21例,有效16例,无效3例;对照组显效15例,有效13例,无效12例,两组疗效比较差异有统计学意义(P<0.05)。(3)精神量表评分:治疗后观察组患者的HAMA、HAMD评分均显著低于对照组,差异有统计学意义(P<0.01)。(4)药物不良反应:观察组的不良反应主要为恶心、头昏、便秘、乏力,发生在用药1周内,第2周消失。结论难治性IBS患者普遍存在抑郁、焦虑等情绪障碍,抗抑郁药文拉法辛联合马来酸曲美布汀及双歧三联活菌治疗能显著改善患者躯体及精神两方面的症状,且安全、有效。Objective To investigate the therapeutic effect of venlafaxine and trimebutine and bifidobiogen on refractory irritable bowel syndrome.Methods 80 patients with refractory IBS were randomly divided into control group and treatment group,with each 40 patients.Patients in control group received conventional treatment（trimebutine and bifidobiogen）.Patients in treatment group received venlafaxine,5-hydroxytryptamine in addition to all the conventional treatments in control group.The course of treatment was 12 weeks.Before and after treatment all patients were graded with symptom severity and symptom frequency,as well as with Hamilton anxiety scale and Hamilton depression scale.Results（1）Digestive tract symptom：symptom seriousness exponent and symptom frequency exponent of treatment group were significantly lower than those of control group（P0.01）.（2） Curative effect：the effective rate of treatment group was 92.5%,and control group was 70.0%,the difference was significant（P0.05）.（3） Hamilton anxiety scale and Hamilton depression scale in treatment group were significantly lower than those in control group（P0.05）.（4）Side effects of medicine：dizziness,hypodynamia,nausea,constipation were frequently shown in treatment group in the first week,and they disappeared after 1～2 week.Conclusion Most refractory IBS patients are with anxiety and depression disturbance.Antidepressants combined with trimebutine and bifidobiogen can significantly improve somatic and mental symptom,and it is safe and effective.

关 键 词：肠易激综合征 抗抑郁药 治疗结果 

分 类 号：R574[医药卫生—消化系统]