文拉法辛联合奥氮平治疗功能性胃肠病伴明显焦虑障碍55例  

Venlafaxine combined with olanzapine in the treatment of functional gastrointestinal disorders with significant anxiety disorder:55 cases

作　　者：陈秀秉[1] 韦月辉[2] 钟健 黄小丽 廖健宏 邹尤宝[1] CHEN Xiubing;WEI Yuehui;ZHONG Jian;HUANG Xiaoli;LIAO Jianhong;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11期2283-2286,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较文拉法辛联合奥氮平治疗功能性胃肠病(FGIDs)伴明显焦虑障碍病人的临床疗效。方法选取2018年1-9月在钦州市第一人民医院住院治疗的110例FGIDs病人为研究对象,采用随机数字表法分为对照组和观察组各55例。两组病人均给予调节肠道菌群、抑酸护胃等基础治疗,对照组加服文拉法辛治疗,观察组在此基础上联合服用奥氮平治疗,疗程为24周。比较两组病人治疗开始0、1、2、4、24周的消化道症状(GSRS)、汉密尔顿焦虑量表(HAMA)以及汉密尔顿抑郁量表(HAMD)评分,比较治疗期间两组病人的不良反应发生情况。结果治疗后两组病人的GSRS、HAMA、HAMD评分均明显下降(均P<0.001)。治疗1周后,观察组HAMA、HAMD评分均低于对照组(均P<0.05)。对照组与观察组不良反应发生率(66.7%比69.4%)比较,差异无统计学意义(P=0.771)。结论对伴明显焦虑障碍FGIDs病人,文拉法辛能有效改善焦虑抑郁症状,但加入小剂量奥氮平后起效更快、效果更明显,具有较高安全性,值得临床推广。Objective To compare the clinical efficacy of venlafaxine combined with olanzapine in patients with functional gastroenteropathy(FGIDs)with significant anxiety disorder.Methods A total of 110 patients with FGIDs in the First People’s Hospital of Qinzhou from January 2018 to September 2018 were selected as study subjects and randomly divided into the control group(55 cases)and the observation group(55 cases).All patients were given basic treatment such as intestinal flora regulation,acid inhibition and gastric protection.The control group was treated with venlafaxine,and the observation group was treated with olanzapine on this basis for 24 weeks.Gastrointestinal symptoms score(GSRS),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were scored and compared between the two groups at 0,1,2,4 and 24 weeks,and adverse reactions were statistically analyzed.Results GSRS,HAMA and HAMD scores of patients in the two groups after treatment were significantly lower than those before treatment(all P<0.001).After 1 week of treatment,HAMA and HAMD scores in the observation group were significantly lower than those in the control group(all P<0.05).The incidence of adverse reactions in the observation group(69.4%)was slightly higher than that in the control group(66.7%),and the difference was not statistically significant(P=0.771).Conclusion For FGIDs patients with obvious anxiety disorder,venlafaxine can effectively improve the symptoms of anxiety and depression,but the addition of small doses of olanzapine has faster onset,more obvious effect and also safety,which is worthy of clinical promotion.

关 键 词：胃肠疾病/药物疗法 功能性胃肠病 焦虑 奥氮平 文拉法辛 疗效 

分 类 号：R57[医药卫生—消化系统] R749.72[医药卫生—内科学]