舍曲林联合三联疗法治疗幽门螺杆菌阳性消化性溃疡合并抑郁症的疗效  

Efficacy of Sertraline hydrochloride tabletscombined with triple therapyonpeptic ulcer and depression in patients with Helicobacter pylori infection

作　　者：陈春凤[1] 高静芳[1] 朱翔贞[1] 钦丹萍[2] 刘彩霞[3] 

机构地区：[1]浙江中医药大学附属第一医院心理精卫科,浙江杭州310006 [2]浙江中医药大学附属第一医院消化科 [3]浙江医院精神卫生科,浙江杭州310007

出　　处：《中华全科医学》2016年第5期807-809,共3页Chinese Journal of General Practice

基　　金：2015年浙江省医药卫生一般研究计划(2015KYA-004)

摘　　要：目的研究舍曲林治疗幽门螺杆菌（Hp）阳性消化性溃疡合并抑郁症的疗效。方法166例Hp阳性消化性溃疡合并抑郁症患者被随机分为治疗组86例和对照组80例。2组均给予相同的三联疗法治疗Hp阳性消化性溃疡，治疗组采用舍曲林治疗抑郁症，对照组采用阿米替林治疗抑郁症。观察2组的腹痛程度、电子胃镜检查结果、Hp清除率、HAMD评分结果和药物不良反应。结果166株Hp菌株对甲硝唑的耐药率较高，为75．9％；而对阿莫西林、左氧氟沙星、呋喃唑酮、克拉霉素的耐药率较低。治疗8周后，2组的腹痛程度均比治疗前显著下降且治疗组的腹痛程度比对照组低，差异均有统计学意义（P〈0．05）；2组的HAMD评分结果分别为（12．4±3．6）分和（19．0±3．9）分，均比治疗前显著下降且治疗后治疗组的HAMD评分结果比对照组低，差异均有统计学意义（P〈0．05）；治疗组的显效率为55．8％，总有效率为89．5％；治疗组的显效率和总有效率均显著高于对照组（χ^2=10．597、6．019，均P〈0．05）。治疗组的Hp清除率为93．0％（80／86），对照组的Hp清除率为78．8％（63／80），治疗组的Hp清除率比对照组高，差异有统计学意义（P〈0．05）。2组不良反应发生率，差异无统计学意义（χ^2=1．457，P〉0．05）。结论舍曲林联合三联疗法可治疗Hp阳性消化性溃疡合并抑郁症，且不良反应较少，具有较高的临床推广价值。Objective To study efficacy of Sertraline hydrochloride tablets in the treatment of peptic ulcer and depression in patients with Helicobaeter pylori infection. Methods Total 166 cases of Hp-positive peptic ulcer patients with depression were randomly divided into treatment group （86 cases） and control group （80 cases）. The two groups were given the same triple therapy to treat Hp positive peptic ulcer, thetreatment group was given sertraline to treat thedepression, and the control group was given amitriptyline to treatdepression. The degree of pain, results of the electronic gastroscopy, Hp clearance rate,HAMD score and adverse drug reactions were observed. Results Total 166 Hp strains（75.9% ） were highly resistant to metronidazole, but lowresistant to amoxicillin, levofloxacin, furazolidone andclarithromycin. After8 weeks oftreatment, abdominal pain was improved significantly in both groups, andthe treatment group was better than the control group,the difference was statistically significant（ P 〈 0.05 ）. HAMD score for the two groups was （12.4 ± 3.6） and （19.0 ± 3.9 ）, respectively, significantly decreased after thetreatment, and the HAMD score in the treatment group was lower than that in the control group, the difference was statistically significant （ P 〈 0.05 ）. The efficiency of the treatment group was 55.8% ,the total efficiency was 89.5%, the markedly effective rate and total effective rate in the treatment group was significantly higher（ χ^2 = 10. 597,6. 019, all P 〈0.05 ） as compared with the control group. Hp clearance rate in treatment group was 93.0% （80/86） and in the control group was 78.8% （63/80）, the difference was statistically significant（ P 〈 0.05 ）. The incidence of adverse reactions was no statistically significant （ χ^2= 1. 457, P 〉 0.05 ）. Conclusion Sertraline hydrochloride tablets combined with triple therapy can effectivelytreat the depression in Hp positive peptic uleerpatients,with fewer adverse reactions and a high clinic

关 键 词：舍曲林 三联疗法 幽门螺杆菌阳性 消化性溃疡 抑郁症 

分 类 号：R573.1[医药卫生—消化系统] R749.41[医药卫生—内科学]