认知行为干预联合米氮平对功能性消化不良患者的疗效  

Effect and mechanism of cognitive behavioral therapy combined with Mirtazapine on patients with functional dyspepsia

作　　者：张洪艳[1] 郝秀轻[2] 李多[3] 卞睿 张玉平[4] 杨晓静[5] 张海燕[5] ZHANG Hongyan;HAO Xiuqing;LI Duo;BIAN Rui;ZHANG Yuping;YANG Xiaojing;ZHANG Haiyan(The Third Department of Neurology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Pathology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Gastroenterology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Pathophysiology,College of Basic Medicine,Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Outpatient,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院神经内三科,河北张家口075000 [2]河北北方学院附属第一医院病理科,河北张家口075000 [3]河北北方学院附属第一医院消化内科,河北张家口075000 [4]河北北方学院基础医学院病理生理教研室,河北张家口075000 [5]河北北方学院附属第一医院门诊部,河北张家口075000

出　　处：《中国医药导报》2023年第21期167-170,共4页China Medical Herald

基　　金：河北省卫生健康委员会医学科学研究课题计划项目(20200529)。

摘　　要：目的观察认知行为干预联合米氮平对功能性消化不良患者的疗效。方法选择2019年5月至2021年5月河北北方学院附属第一医院临床心理门诊收治的功能性消化不良患者120例,按随机数学表法将其分为对照组和试验组,每组60例。对照组给予米氮平治疗,试验组在米氮平治疗的基础上联合认知行为干预。治疗8周后,比较两组临床疗效、安全性、患者健康问卷(PHQ-15)、5-羟色胺(5-HT)、胃泌素(GAS)、胃动素(MTL)的变化。结果对照组随访丢失6例,因担心抗抑郁药物的副作用丢失2例,试验组随访丢失2例。治疗8周后,试验组临床疗效高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗后,两组PHQ-15、5-HT低于治疗前,且试验组低于对照组(P<0.05)。治疗后,两组GAS、MTL高于治疗前,且试验组高于对照组(P<0.05)。结论在功能性消化不良治疗中,认知行为干预联合米氮平治疗方案优于单用米氮平治疗,不仅能改善多种躯体不适症状,而且能更好地改善胃肠动力学相关指标,值得临床推广应用。Objective To observe the effect and mechanism of cognitive behavioral therapy combined with Mirtazapine on patients with functional dyspepsia.Methods A total of 120 patients with functional dyspepsia admitted to the psychological clinic of the First Affiliated Hospital of Hebei North University from May 2019 to May 2021 were selected.They were divided into control group and experimental group according to the random table method,with 60 cases in each group.The control group was treated with Mirtazapine,and the experimental group was treated with Mirtazapine combined with cognitive behavior therapy.The clinical efficacy,safety,patient health questionnaire(PHQ-15),5-hydroxytryptamine(5-HT),gastrin(GAS)and motilin(MTL)were compared between the two groups after eight weeks of treatment.Results In the control group,six patients were lost during follow-up,two patients were lost because of worrying about the side effects of antidepressants.And two patients were lost during follow-up in the experimental group.The clinical efficacy of the experimental group was higher than that of the control group after eight weeks of treatment(P<0.05).There was no significant difference in total incidence of adverse reactions between the two groups(P>0.05).After treatment,PHQ-15 and 5-HT in two groups were lower than before treatment,and experimental group was lower than control group(P<0.05).After treatment,GAS and MTL of the two groups were higher than those before treatment,and experimental group was higher than control group(P<0.05).Conclusion In the treatment of functional dyspepsia,cognitive behavioral therapy combined with Mirtazapine is superior to Mirtazapine alone,which can not only improve a variety of somatic discomfort symptoms,but also better improve the related indexes of gastrointestinal dynamics,it is worthy of clinical application.

关 键 词：功能性消化不良 米氮平 认知行为干预 

分 类 号：R473[医药卫生—护理学]