阿米替林片联合匹维溴铵片治疗腹泻型肠易激综合征的临床研究  

Clinical trial of amitriptyline tablets combined with pinaverium bromide tablets in the treatment of diarrhea type irritable bowel syndrome

作　　者：戴蕾[1] 陈明显[1] 傅睿[1] 夏亮[1] 费保莹[1] 沈堂彪[1] DAI Lei;CHEN Ming-xian;FU Rui;XIA Liang;FEI Bao-ying;SHEN Tang-biao(Department of Gastroenterology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院消化内科,杭州310012

出　　处：《中国临床药理学杂志》2018年第19期2269-2272,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81302957);浙江省自然科学基金资助项目(LY17H270003);浙江省"十三五"中医药(中西医结合)重点学科建设计划基金资助项目(2017-XK-A24);浙江省科技厅院所专项基金资助项目(2017F30044);浙江省中医药科技计划基金资助项目(2018ZA022);浙江省医药卫生科技计划基金资助项目(2018KY326)

摘　　要：目的观察小剂量阿米替林联合匹维溴铵治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法按随机数表法,将2013年6月至2016年6月本院收治的125例年龄为18～65岁IBS-D患者分为对照组(63例)和试验组(62例)。对照组给予匹维溴铵片治疗,每次50 mg,3次/天;试验组在对照组治疗基础上给予阿米替林联合治疗,阿米替林每次25 mg,1次/天,2组患者疗程均为4周。用肠易激综合征(IBS)症状尺度表(BSS)、IBS大便性状问卷(IBS-DSQ)、生活质量问卷(IBS-QOL)方法观察2组患者在治疗前后的主要症状和生活质量状况,评估匹维溴铵单用和与阿米替林联用时的临床疗效。结果经4周治疗后,对照组与试验组的IBS-BSS总有效率分别为61.90%(39例/63例)和85.48%(53例/62例);这2组的IBS-BSS总积分分别为(166.32±72.75),(112.98±81.84)分;这2组的大便性状总有效率分别为71.43%(45例/63例)和91.94%(57例/62例);试验组的IBS-QOL总积分显著高于对照组,上述指标在组间比较差异均有统计学意义(均P<0.01)。结论阿米替林与匹维溴铵联用较匹维溴铵单用能更有效地改善患者的肠道症状、大便性状,并能更加显著地提高患者生活质量。Objective To observe the efficacy of pinaverium bromide alone or in combination with amitriptyline in the treatment of diarrhea type irritable bowel syndrome（ IBS-D）. Methods One hundred and twenty-five patients with IBS-D,aged 18-65 years,in our hospital from June 2013 to June 2016 were randomly divided into control group（ 63 cases,treated with pinaverium bromide 50 mg,tid） and treatment group（ 62 cases,on the basis of control group,treated with amitriptyline25 mg,qd）. The total effective rate,the stool property and state,and the quality of life were assessed by IBS-bowel symptom severity scale（ IBS-BSS）,IBS-defecation state questionnaire（ IBS-DSQ） and the IBS-quality of life questionnaire（ IBS-QOL） before and 4 weeks after the treatment respectively. Results After treatment,the IBS-BSS efficacy of the control group and the treatment group were 61. 90%（ 39 cases/63 cases） and 85. 48%（ 53 cases/62 cases）,respectively,and the difference were statistically significant（ P〈0. 01）. Total IBS-BSS scores of the control group and the treatment group were（ 166. 32 ± 72. 75）,（ 112. 98 ± 81. 84） point,respectively; which was significantly decreased in the treatment group（ P〈0. 01）. The IBS-DSQ effective rates of the control group and the treatment group were 71. 43%（ 45 cases/63 cases） and 91. 94%（ 57 cases/62 cases）,respectively; which was significantly increased in the treatment group than that in the control group（ P〈0. 01）. Moreover,the total IBS-QOL integrals were statistically increased in the two groups,with the treatment group more pronounced. Conclusion Pinaverium bromide in combination with amitriptyline could effectively relieve bowel symptoms,improve the stool property and the defecation frequency and thus improve their quality of life,which has a certain clinical application value.

关 键 词：阿米替林片 匹维溴铵片 腹泻型肠易激综合征 联合治疗 

分 类 号：R975[医药卫生—药品]