盐酸氟西汀、匹维溴铵联合小剂量阿米替林治疗肠易激综合征疗效观察  

Therapeutic effect of co-treatment with fluoxetine hydrochloride,pinaverium bromide and low-dose amitrip-tyline for irritable bowel syndrome

作　　者：杨宏[1] 丁顺斌[2] 

机构地区：[1]四川省德阳市精神卫生中心,618013 [2]德阳市人民医院消化内科

出　　处：《中国临床研究》2013年第10期1031-1032,共2页Chinese Journal of Clinical Research

摘　　要：目的研究盐酸氟西汀、阿米替林、匹维溴铵联合用药治疗肠易激综合征的临床疗效。方法82例符合罗马Ⅲ诊断标准并伴有焦虑和抑郁状态的肠易激综合征患者随机分为治疗组(n=43)和对照组(n=39)。两组均根据患者不同症状进行对症处理。治疗组口服盐酸氟西汀胶囊20 mg qd(早餐时顿服),阿米替林6.25 mg qn,匹维溴铵片100mg tid,疗程8周。对照组仅予对症处理。应用症状变化评定疗效标准及汉密尔顿抑郁量表((HAMD,17项)于治疗前及治疗8周后进行疗效评定。结果治疗后肠易激综合征症状缓解总有效率,治疗组为90.7%(39/43),对照组为53.8%(21/39),治疗组明显优于对照组(P<0.05);治疗8周后的HAMD总分,治疗组显著低于对照组(6.27±1.54 vs 15.04±5.86,P<0.05)。两组治疗中、治疗后血常规、肝肾功能、电解质及心电图检查均无异常变化。结论盐酸氟西汀、阿米替林、匹维溴铵联合治疗肠易激综合征疗效确切。Objective To study the efficacy of combination treatment of fluoxetine hydrochloride,amitriptyline and pinaverium bromide for irritable bowel syndrome. Methods A total of 82 patients with irritable bowel syndrome according with Roman 鈪？diagnostic standard and having anxiety and depression state were randomly divided into treatment group（n=43） and control group（n=39）. The expectant treatment was all given according to different symptoms of patients in two groups. In treatment group,fluoxetine hydrochloride capsule 20mg qd（draught in morning meal）,amitriptyline 6.25 mg qn and pinaverium bromide 100mg tid were administered,The course of treatment was 8 weeks. In control group,expectant treatment was taken only. The efficacy evaluation was conducted by changes of symptom evaluation criteria and the Hamilton depression scale（HAMD,17 items） before treatment and 8weeks after treatment. Results The total effect rate of symptom remission in treatment group was higher than that in control group（90.7%vs53.8%,P0.05）. HAMD total points 8 weeks after treatment in treatment groups was lower than that in control group（6.27卤1.54vs15.04卤5.86,P0.05）. The abnormalities of blood routine,liver and kidney functions,electrolyte and electrocardiogram in treatment and after treatment were not observed in two groups. Conclustions The efficacy of co-treatment with fluoxetine hydrochloride,amitriptyline and pinaverium bromide is definite for irritable bowel syndrome.

关 键 词：肠易激综合征 焦虑 抑郁 氟西汀 阿米替林 匹维溴铵 

分 类 号：R574.4[医药卫生—消化系统]