米氮平联合匹维溴胺治疗腹泻型肠易激综合征的疗效及相关机制研究  

Effect and mechanism of combination of mirtazapine with pinaverium bromide in treatment of IBS-D

作　　者：李乾[1] 吴娟 李新华[1] 张桂英[1] 

机构地区：[1]中南大学湘雅医院消化内科,湖南长沙410008 [2]湖南省马王堆疗养院消化科,湖南长沙410001

出　　处：《中国现代医学杂志》2012年第7期52-55,共4页China Journal of Modern Medicine

摘　　要：目的研究米氮平和匹维溴胺联合治疗腹泻型肠易激综合征(IBS-D)的疗效及相关机制探讨。方法将42例符合罗马Ⅲ诊断标准的腹泻型肠易激综合征患者进行焦虑和抑郁自评量表评分后,随机分为两组:联合组22例应用米氮平加匹维溴胺;对照组20例单用匹维溴胺,疗程均为4周,疗程结束后评估腹痛腹泻症状的改善情况。同时于治疗前和治疗4周后抽血标本,进行降钙素基因相关肽的放射免疫检测。结果患者的SAS均分为(45.33±8.12)分,SDS均分为(56.14±8.07)分。联合组对IBS腹痛和腹泻症状的改善均显著优于对照组(分别为Z=-2.266,P=0.023和Z=-2.139,P=0.032)。联合组治疗后降钙素基因相关肽水平显著降低(t=199.02,P<0.001)。结论 IBS-D患者存在不同程度的抑郁状态。匹维溴铵联合米氮平治疗IBS-D疗效显著优于单用匹维溴铵。米氮平治疗IBS的机制可能与降低降钙素基因相关肽水平有关。【Objectives】 To study the effect of combination of Mirtazapine with Pinaverium Bromide in treatment of IBS-D and their underlying mechanisms.【Methods】 Based on Rome Ⅲ criteria,42 IBS-D patients were chosen in this study.These patients were evaluated with self-rating Anxiety Scale（SAS） and self-rating Depression Scale（SDS）.Then,all 42 IBS were divided into two groups randomly： United-treatment group would be treated with Mirtazapine and Pinaverium Bromide for 4 weeks.Control group only would be treated with Pinaverium Bromide for 4 weeks.Symptoms improving of abdominal pain and diarrhea were evaluated in 42 patients after 4 weeks.The plasma levels of CGRP were measured by radioimmunoassay before treatment and after 4 weeks.【Results】 The SAS score average of all patients were（45.33±8.12）,SDS score average were（56.14±8.07）.The improving efficiency of abdominal pain and diarrhea in united-treatment group were significantly higher than that in control group（Z =-2.266,P =0.023 and Z =-2.139,P =0.032,respectively）.There was a significant difference in the plasma level of CGRP comparison before treatment with after 4 weeks in united-treatment group（P =0.001）.【Conclusions】 There were various degrees of depression in patients with IBS-D.Therapeutic effects of Mirtazapine and Pinaverium Bromide on IBS-D were significantly more efficient than that of Pinaverium Bromide alone.Therapeutic effect of Mirtazapine on IBS-D may be associated with reducing the plasma level of CGRP.

关 键 词：米氮平 匹维溴铵 腹泻型肠易激综合征 降钙素基因相关肽 

分 类 号：R574.4[医药卫生—消化系统]