氟哌噻吨美利曲辛联合布拉酵母菌治疗伴有焦虑抑郁状态的腹泻型肠易激综合征患者的疗效评估  

Evaluation of therapeutic effects of flupentixol and melitracen combined with Saccharomyces boulardii on patients with diarrhea-predominant irritable bowel syndrome accompanied with anxiety and depression

作　　者：彭涛[1] 刘玉兰[1] 夏志伟[2] 秦耿[3] 赵洪川[3] 朱丽明[4] 钱家鸣[4] 

机构地区：[1]北京大学人民医院消化科, 100044 [2] 北京大学第三医院消化科 [3] 中日友好医院消化科 [4] 北京协和医院消化科

出　　处：《中华消化杂志》2015年第2期122-126,共5页Chinese Journal of Digestion

摘　　要：目的 观察氟哌噻吨美利曲辛联合布拉酵母菌治疗伴有焦虑抑郁状态的腹泻型IBS患者的疗效.方法 本研究为多中心、随机、前瞻性研究.将纳入的84例腹泻型IBS患者分成联合治疗组（42例）和对照组（42例）,两组患者均口服布拉酵母菌,其中联合治疗组加用氟哌噻吨美利曲辛,疗程为4周.于治疗前、治疗1周、治疗4周时进行胃肠道症状和情绪障碍评估,并观察不良反应.统计学分析采用卡方检验.结果 治疗后1周,联合治疗组与对照组的胃肠道症状改善有效率分别为31.0％（13/42）和23.8％（10/42）,差异无统计学意义（P＞0.05）;治疗后4周,联合治疗组的胃肠道症状改善有效率为92.5％（37/40）,高于对照组的73.2％（30/41）,差异有统计学意义（x2=5.291,P=0.037）.治疗后1周,联合治疗组与对照组的汉密尔顿抑郁量表评分改善的有效率分别为31.6％（12/38）和12.1％（4/33）,差异无统计学意义（P＞0.05）;治疗后4周,联合治疗组汉密尔顿抑郁量表评分改善的有效率为63.9％（23/36）,高于对照组的34.4％（11/32）,差异有统计学意义（x2=6.433,P=0.043）.治疗后1和4周,联合治疗组汉密尔顿焦虑量表评分改善的有效率分别为35.7％（15/42）和80.0％（32/40）,分别高于对照组的15.4％（6/39）和34.2％（13/38）,差异均有统计学意义（x2=9.759,P=0.007;x2=17.105,P＜0.01）.治疗后1周,联合治疗组和对照组的不良反应发生率分别为4.8％（2/42）和4.8％（2/42）;治疗后4周,联合治疗组和对照组的不良反应发生率分别为2.5％（1/40）和2.4％（1/41）;两组不良反应发生率差异均无统计学意义（P均＞0.05）.结论 氟哌噻吨美利曲辛联合布拉酵母菌治疗不仅可有效改善腹泻型IBS患者的焦虑抑郁症状,而且还可有效改善患者的消化道症状,效果明显优于单用布拉酵母菌治疗.Objective To assess the therapeutic effects of flupentixol and melitracen tablets combined with Saccharomyces boulardii on patients with diarrhea-predominant irritable bowel syndrome （IBS） accompanied with anxiety and depression.Methods This multi-center,randomized,prospective study enrolled 84 patients with diarrhea-predominant IBS who were divided into combined treatment group （42 patients） and control group （42 patients）.Saccharomyces boulardii was administrated in both of the groups,and flupentixol and melitracen was added in combined treatment group.The treatment course was four weeks.The gastrointestinal symptoms and mood disorders were evaluated before treatment,one week and four weeks after treatment.Adverse reactions were also observed.Chi-square test was performed for statistical analysis.Results At the end of one week after treatment,the efficacy rates of gastrointestinal symptoms improvement of combined treatment group and control group were 31.0% （13/42） and 23.8% （10/42）,and there was no statistically significant difference （P〉0.05）.At the end of four weeks after treatment,the efficacy rate of gastrointestinal symptoms improvement of combined treatment group was 92.5% （37/40）,which was higher than that of control group （73.2%,30/41）,and the difference was statistically significant （x2 =5.291,P =0.037）.At the end of one week after treatment,the efficacy rates of Hamilton Depression Scale score improvement of combined treatment group and control group were 31.6% （12/38） and 12.1% （4/33）,and there was no statistically significant difference （P〉0.05）.At the end of four weeks after treatment,the efficacy rates of Hamilton Depression Scale score improvement of combined treatment group was 63.9% （23/36）,which was higher than that of control group （34.4%,11/42）,and the difference was statistically significant （x2 =6.433,P=0.043）.At the end of one week and four weeks after treatment,the efficacy rates of Hamilton Depression Scale score improveme

关 键 词：肠易激综合征 焦虑 抑郁 布拉酵母菌 氟哌噻吨美利曲辛 

分 类 号：R574[医药卫生—消化系统]