米氮平治疗功能性消化不良疗效评价  

Retrospective Evaluation for the Efficacy of Mirtazapine on Functional Dyspepsia

作　　者：朱丽明[1] 常敏[1] 黄丹[1] 史丽丽[2] 方秀才[1] 柯美云[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院心理医学科,北京100730

出　　处：《临床消化病杂志》2011年第2期71-72,83,共3页Chinese Journal of Clinical Gastroenterology

基　　金："十一五"国家科技支撑计划课题(2007BAI04BO1)

摘　　要：目的已有使用抗抑郁药治疗功能性消化不良(FD)合并心理障碍的报道,本研究总结评价去甲肾上腺素和5-羟色胺再摄取抑制剂米氮平治疗FD的疗效及安全性。方法收集北京协和医院消化内科2009年6月～2010年6月接受米氮平治疗的FD患者资料,随诊内容包括消化不良症状、食欲和体重、精神心理状态和睡眠情况等。总结分析米氮平的疗效和不良反应。结果研究纳入符合罗马Ⅲ诊断标准FD患者50例,男性11例,女性39例,平均年龄46.6±12.7岁。米氮平治疗起始剂量以10 mg为主;有效维持剂量为15 mg(46%)、30 mg(22%);疗程2周～12月。治疗后46例患者报告总体症状改善,31例首发表现为消化道症状改善;治疗后患者食量增加(34例),体重增加(24例),睡眠改善(28例),部分患者合并存在的抑郁焦虑改善。5例出现不良反应,分别为乏力、恶心、血白细胞减低等。结论米氮平可有效改善FD患者消化不良的症状,同时增加患者的食欲和体重,改善其睡眠和精神心理状态,不良反应较少。Objective Antidepressants are prescribed for patients with functional dyspepsia（FD） while they are failed to regular medications. There was less experience about noradrenaline and serotonin re-uptake inhibitor-mirtazapine on FD patients with psychological disorders. The aim of this study is to evaluate the efficacy and safety of mirtazapine in treatment for FD patients.Methods The retrospective data were colected for the patients with FD who were treated with mirtazapine and followed-up at least two weeks in clinic of Peking union medical college hospital from June 2009 to June 2010.The patient＇ s dyspeptic symptoms,treatment,psychological status were analyzed. Results A total of 50 FD patients（11 male and 39 female） met RomeⅢcriteria were enrolled.Mean age was 46.6±12.7 years.Mirtazapine at the beginning dose is at 10 mg for most cases,and maintenance dose is 15 mg for 46%,and 30 mg for 22%cases.The course of treatment was 2 weeks to 12 months.Of 46 patients reported their global symptoms improved after mirtazapine treatment,dyspeptic symptoms were at the first list improved symptoms in 31 patients.Body weight increased for 24 patients,and sleep improved for 28 patients,and co-exist psychological disorders also improved in some cases.The adverse effects associated with mirtazapine occur in 5 cases（fatigue,nausea and leukocytes decrease）.Conclusion The retrospective data show mirtazapine is effctive on improve integrative symptoms with FD patients and the adverse effect is fewer.

关 键 词：功能性消化不良 米氮平 抗抑郁剂 

分 类 号：R57[医药卫生—消化系统]