联合抗抑郁药用于不同亚型功能性消化不良的疗效分析  

Efficacy of conventional medicine combined antidepressants on different subtypes functional dyspepsia

作　　者：余琼 徐鹏[2] 张刚 陈兰 肖丹 夏伶俐 贾业贵 YUQiong;XU Peng;ZHANG Gang;CHEN Lan;XIAO Dan;XIA Ling-li;JIA Ye-gui(Department of Gastroenterology,Wuhan Sixth Hospital,430015 Wuhan,Hubei,China;Department of Spleen,Stomach and Lung Diseases,Shiyan Hospital Affiliated to Hubei University of Traditional Chinese Medicine,442012 Shiyan,Hubei,China)

机构地区：[1]武汉市第6医院消化内科,湖北武汉430015 [2]十堰市中医医院脾胃肺病科,湖北十堰442012

出　　处：《临床消化病杂志》2019年第6期354-359,共6页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]研究常规治疗消化不良药物联合抗抑郁药对不同亚型功能性消化不良(functional dyspepsia,FD)患者的疗效及精神心理因素的影响。[方法]基于罗马Ⅳ诊断标准,收集符合FD的患者135例,依据症状表现所属临床亚型分为餐后不适综合征(PDS)型、上腹痛综合征(EPS)型以及PDS+EPS型(重叠型),每个亚型各45例,再依据患者治疗方案和用药情况将各型分为常规治疗组(A组)、抗抑郁组(B组)、联合用药组(C组)各15例。A组选用胃动力药、制酸药治疗,B组予抗焦虑抑郁治疗,C组联合应用A组和B组的治疗方法,疗程均为8周。比较不同类型FD患者的各组治疗前后的症状量化积分、SDS及HAMD评分,分析各组用药对FD患者消化道症状及焦虑/抑郁程度的影响。[结果]各型的各组治疗前的症状量化积分、SDS及HAMD评分比较均差异无统计学意义(P>0.05),各型的各组治疗前与治疗后症状量化积分、SDS及HAMD评分比较均差异有统计学意义(P<0.05)。各型的A组、B组治疗后症状量化积分、SDS及HAMD评分与C组比较,均差异有统计学意义(P<0.05~0.01)。[结论]对于各亚型FD患者,治疗消化不良药联合抗抑郁药疗效均明显好于单独采用消化不良药或抗抑郁药,联合用药方案具有协同治疗作用,因此对各亚型FD的患者在常规胃动力药和制酸药的基础上加用抗焦虑抑郁的联合用药方案可取得更加满意的临床疗效。[Objective]To study the effects of Flupentixol and Melitracen Tablets combined with Trimebutin Maleate Dispersible Tablets on different subtypes of functional dyspepsia.[Methods]Based on RomeⅥdiagnostic criteria,135 patients with functional dyspepsia(FD)were randomly divided into three different groups which were postprandial discomfort syndrome(PDS)group,upper abdominal pain syndrome(EPS)group and PDS overlapping EPS group,and 45 patients in each group.Every group was randomly divided with the experimental group and the control group.The experimental group was treated with Flupentixol and Melitracen Tablets.The quantitative score of symptoms,SDS and HAMD scores of each subtype group of FD patients before and after treatment were compared and the changes of digestive tract symptoms and anxiety/depression levels of FD patients after combined treatment with Flupentixol and Melitracen Tablets with Trimebutin Maleate Dispersible Tablets were analyzed.[Result]①Comparison between the same subtype experimental group:PDS experimental group showed significant difference in improving symptoms of upper abdominal pain,anti-acid and early satiety compared with the control group(P<0.05).There was a significant difference between the EPS group and the control group in improving postprandial discomfort,anti-acid and early satiety(P<0.05).Compared with the control group,the overlapping experimental group showed significant difference in the improvement of anti-acid,early satiety and belching symptoms(P<0.05).②There was a significant difference in SDS and HAMD scores between each subtype group after treatment and before treatment(P<0.05).③After treatment,SDS and HAMD scores of patients in each subtype experimental group decreased significantly more than those of the control group,and there was a significant difference between the two groups(P<0.01).[Conclusion]For patients with functional subtypes of dyspepsia,the efficacy of treatment of dyspepsia drugs combined with antidepressants is significantly better than single tre

关 键 词：功能性消化不良 氟哌噻吨美利曲辛片 焦虑抑郁状态 

分 类 号：R723.1[医药卫生—儿科]