文拉法辛与黛力新治疗功能性胃肠病伴焦虑障碍的疗效对比  

Comparison of the efficacy of venlafaxine and Deanxit in treating functional gastrointestinal disorder with anxiety

作　　者：陈秀秉[1] 韦月辉[2] 钟健 邹尤宝[1] CHEN Xiubing;WEI Yuehui;ZHONG Jian;ZOU Youbao(Department of Gastroenterology,The First People’s Hospital of Qinzhou,Qinzhou,Guangxi 535000,China;Nursing Department,The Second People’s Hospital of Qinzhou,Qinzhou,Guangxi 535000,China)

机构地区：[1]钦州市第一人民医院消化内科,广西钦州535000 [2]钦州市第二人民医院护理部,广西钦州535000

出　　处：《安徽医药》2020年第1期174-178,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析比较文拉法辛及黛力新对功能性胃肠病(FGIDs)伴焦虑抑郁障碍患者的临床疗效。方法选取2017年3月至2018年1月在广西钦州市第一人民医院收治的FGIDs病人218例。采用随机数字表法分为文拉法辛组(108例)与黛力新组(110例),文拉法辛组有7例失访,有1例治疗2周后坚决要求停药而终止治疗,实际纳入研究为100例;而黛力新组有8例失访,有2例因未遵嘱服药而移出研究,故实际纳入研究为100例。两组均予以抑酸、促动力等常规治疗,在此基础上,文拉法辛组加服文拉法辛治疗,黛力新组加服黛力新治疗,疗程为24周。第0、第1、第2、第4、第8、第24周对两组进行消化道症状评分(GSRS评分)、汉密尔顿焦虑量表(HAMA)评分以及SAS焦虑量表评分;根据SAS评分对两组病人进行焦虑程度分级(分为重度、中度以及轻度),比较第0周、第24周两组重度、中度以及轻度焦虑FGIDs病人GSRS评分;比较第0周、第24周两组各类型FGIDs病人GSRS评分。结果治疗后两组病人的GSRS、HAMA、SAS评分较治疗前均明显下降(P<0.001)。治疗24周后,文拉法辛组功能性便秘病人的GSRS评分显著低于黛力新组[(0.94±1.18)比(3.52±3.22),F=7.756,P=0.009],胃食管反流病人的GSRS评分显著低于黛力新组[(0.62±0.50)比(4.35±3.14),F=22.680,P<0.001];文拉法辛组重度焦虑病人GSRS评分显著低于黛力新组[(1.75±2.26)比(5.50±2.99),t=6.003,P=0.000],中度焦虑病人GSRS评分显著低于黛力新组[(0.83±0.91)比(2.43±2.47),t=3.604,P=0.000]。文拉法辛组病人不良反应发生率(78.00%)显著高于黛力新组(49.00%),差异有统计学意义(P<0.001)。结论对伴有焦虑障碍的FGIDs病人,黛力新和文拉法辛均能明显改善病人消化道症状,有效缓解焦虑障碍,但文拉法辛对中重度焦虑的FGIDs病人以及胃食管反流、功能性便秘病人的疗效更好。Objective To compare the efficacy of venlafaxine and Deanxit in treating functional gastrointestinal disorders(FGIDs)with anxiety.Methods A total of 218 patients with FGIDs in the First People’s Hospital of Qinzhou from March 2017 to January 2018 were selected and randomly divided into venlafaxine group(108 cases)and Deanxit group(110 cases).Seven patients were lost to follow⁃up,and 1 patient was resolutely requested to discontinue treatment after 2 weeks of treatment in the venlafaxine group,Venlafaxine group included 100 patients actually.8 patients were lost to follow⁃up,and 2 patients were removed from the study because they did not follow doctor’s advice on the medication in the Deanxit group.Therefore 100 cases was included in the Deanxit group ultimately.All patients were given conventional treatment such as acid suppression and kinetic stimulation.The venla⁃faxine group was additionally treated with venlafaxine.The Deanxit group was additionally treated with Deanxit.The treatment course is 24 weeks.Gastrointestinal symptoms and anxiety of patients in the two groups were evaluated by Gastrointestinal Symptom Rating Scale(GSRS scores),Hamilton Anxiety Scale(HAMA scores),and Self⁃Rating Anxiety Scale(SAS scores)at 0,1,2,4,8,and 24 weeks.The anxiety level(severe,moderate,and mild)of the two groups was graded according to the SAS scores,and then the GSRS scores of FGIDs patients with different levels of anxiety(severe,moderate,mild anxiety)at 0 week and 24 weeks were compared between the two groups.GSRS scores for various types of FGIDs patients at 24th week were compared between the two groups.Results After treatment,GSRS scores significantly decreased in both groups(P<0.001).After 24 weeks of therapy,the GSRS scores of patients with functional constipation were significantly lower in the venlafaxine group than those in the Deanxit group(0.94±1.18 vs.3.52±3.22,F=7.756,P=0.009),the GSRS scores of patients with gastroesophageal reflux were significantly lower in the venlafaxine group than those in

关 键 词：胃肠疾病 消化不良 抑郁症 文拉法辛 疏肝解郁药 胃食管反流 便秘 功能性胃肠病 焦虑 黛力新 

分 类 号：R57[医药卫生—消化系统]