米氮平治疗中-重度腹泻型肠易激综合征40例疗效评价  

Efficacy Assessment of Mirtazapine for the Treatment of 40 Patients with Moderate-to-Severe Diarrhea-predominant Irritable Bowel Syndrome

作　　者：宋军民[1] 何强[2] 郝庆[1] 李岩[1] 

机构地区：[1]中国医科大学附属盛京医院消化内科,辽宁沈阳110004 [2]中国医科大学附属盛京医院心理门诊,辽宁沈阳110004

出　　处：《医学临床研究》2014年第9期1754-1757,共4页Journal of Clinical Research

摘　　要：[目的]观察中-重度腹泻型肠易激综合征（IBS-D）患者焦虑和抑郁的共患率,评价米氮平治疗IBS-D的疗效和安全性.[方法]80例中-重度IBS-D（符合罗马Ⅲ诊断标准）患者随机分成两组（每组40例）,分别接受常规治疗和常规治疗＋米氮平;所有患者治疗前后均进行IBS症状严重程度量表（IBS-SSS）评分、IBS生活质量问卷（IBS-QOL）评分和焦虑/抑郁测试（HAMA/HAMD）,并比较治疗后两组的改善情况.[结果]71.3％（57/80）的中-重度IBS-D患者合并焦虑或（和）抑郁;治疗后米氮平组患者IBS-SSS、IBS-QOL和HAMA/HAMD评分较常规治疗组显著下降（P＜0.01）,其中合并焦虑或（和）抑郁患者的IBS-SSS和IBS-QOL得到显著改善（均P＜0.05）;米氮平组17.5％（7/40）的患者发生轻度不良反应.[结论]中-重度IBS-D患者常伴焦虑或（和）抑郁,米氮平的疗效良好,不良反应较轻,可作为中-重度IBS-D的治疗用药之一.[Objective]To explore the comorbidity prevalence of anxiety and depression in patients with moderate-to-severe diarrhea-predominant irritable bowel syndrome（IBS-D）,and to assess the efficacy and safety of mirtazapine in the treatment of these patients.[Methods]Totally 80 patients with moderate-to-severe IBS-D（based on Rome Ⅲ criteria） were randomly divided into two groups with 40 patients in each group.All patients were treated with conventional therapy and conventional therapy in combination with mirtazapine,respectively.IBS symptom severity scale（IBS-SSS）,IBS quality of life questionnare（IBS-QOL） and anxiety/depression test（HAMA/HAMD） were examined before as well as after the treatment,and the improvement between two groups was compared.[Results] The 71.3％ （57/80） of patients with moderate-to-severe IBS-D had anxiety or/and depression.Compared with conditional therapy group,the scores of IBS-SSS,IBS-QOL and HAMA/HAMD in mirtazapine group after treatment were decreased significantly（P ＜0.01）.Moreover,the scores of IBS-SSS and IBS-QOL were significantly improved in those patients with anxiety or/and depression（all P ＜0.05）.Mild side effects happened on 17.5 ％ （7/40） of patients in mirtazapine group.[Conclusion] Anxiety or/and depression can be frequently found in patients with moderate-to-severe IBS-D.Mirtazapine has good efficacy and mild adverse reaction,so it can be used to be one of the drugs for the treatment of patients with moderate-to-severe IBS-D.

关 键 词：抗抑郁药/治疗应用 腹泻/药物疗法 肠易激综合征/药物疗法 治疗结果 

分 类 号：R442.2[医药卫生—诊断学]