益生菌辅助治疗广泛性焦虑障碍患者的短期疗效分析  

Short-term efficacy of probiotic adjuvant therapy in patients with generalized anxiety disorder

作　　者：帅亦斌 王本红 沈仲夏[2] SHUAI Yibin;WANG Benhong;SHEN Zhongxia(Department of Psychosomatic,Huzhou Third Municipal Hospital,Huzhou 313000,Zhejiang Province,China;Sleep Medical Center,Huzhou Third Municipal Hospital,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第三人民医院心身科,浙江湖州313000 [2]湖州市第三人民医院睡眠医学中心,浙江湖州313000

出　　处：《药学前沿》2025年第4期634-641,共8页China Pharmacist

基　　金：湖州市科学技术公益性应用研究项目(2023GZB07)。

摘　　要：目的探究复方嗜酸乳杆菌辅助治疗广泛性焦虑障碍(GAD)的临床疗效和安全性。方法回顾性分析湖州市第三人民医院2021年9月至2023年8月睡眠医学中心诊治的GAD患者的临床资料。根据是否联用益生菌,将患者分为联合组(益生菌联合度洛西汀或帕罗西汀)和单药组(度洛西汀或帕罗西汀)。本研究主要疗效指标为治疗8周临床有效率。次要观察指标为治疗前后焦虑自评量表(SAS)评分、汉密尔顿焦虑量表(HAMA)评分、匹兹堡睡眠质量指数(PSQI)评分、血清神经递质水平[去甲肾上腺素(NE)、5-羟色胺(5-TH)、谷氨酸(Glu)]和血清炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)]水平的变化情况。此外,评估两组患者治疗期间不良反应的发生情况。结果共纳入105例GAD患者,其中联合组40例,单药组65例。治疗8周后,联合组临床有效率显著高于单药组(95.00%vs.80.00%,P<0.05)。与治疗前比较,联合组和单药组治疗后SAS评分、HAMA评分、PSQI评分、NE、5-TH、Glu、CRP、TNF-α和IL-6显著下降(P<0.05),而5-TH水平显著上升(P<0.05)。此外,联合组治疗后SAS评分、HAMA评分、PSQI评分、NE、5-TH、Glu、CRP、TNF-α和IL-6水平显著低于单药组(P<0.05),而5-TH水平显著高于单药组(P<0.05)。在不良反应方面,联合组不良反应发生率低于单药组,但差异无统计学差异(P>0.05)。结论益生菌辅助治疗可提高8周疗效,改善焦虑症状和睡眠质量,其可能是通过调节神经递质和炎症平衡发挥作用。Objective To explore the clinical efficacy and safety of Lactobacillus acidophilus complex as adjuvant therapy for generalized anxiety disorder(GAD),and preliminarily explore its mechanism of action from the perspectives of neurotransmitters and inflammatory factors.Methods The clinical data of GAD patients diagnosed and treated in the Sleep Medical Center of Huzhou Third People's Hospital from September 2021 to August 2023 were retrospectively collected in this study.According to whether probiotics were used in combination,the patients were divided into the combination group(probiotics combined with duloxetine or paroxetine)and the monotherapy group(duloxetine or paroxetine).The primary efficacy indicator of this study was the clinical response rate after 8-week treatment.The secondary observation indicators were the changes in Self-Rating Anxiety Scale(SAS)scores,Hamilton Anxiety Rating Scale(HAMA)scores,Pittsburgh Sleep Quality Index(PSQI)scores,serum neurotransmitter levels[norepinephrine(NE),5-hydroxytryptamine(5-HT),glutamate(Glu)]and serum inflammatory factor levels[C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL 6)]before and after treatment.In addition,the occurrence of adverse reactions during treatment in the two groups was evaluated.Results A total of 105 GAD patients were included in this study,with 40 in the combination group and 65 in the monotherapy group.After 8-week treatment,the clinical response rate of the combination group was significantly higher than that of the monotherapy group(95.00%vs.80.00%,P<0.05).Compared with those before treatment,the SAS scores,HAMA scores,PSQI scores,and the levels of NE,Glu,CRP,TNF-αand IL-6 in both the combination group and the monotherapy group decreased significantly(P<0.05),while the 5-HT level increased significantly(P<0.05).In addition,after treatment,the SAS scores,HAMA scores,PSQI scores,and the levels of NE,Glu,CRP,TNF-αand IL-6 in the combination group were significantly lower than those in the monotherapy group(P<0.0

关 键 词：广泛性焦虑障碍 复方嗜酸乳杆菌 神经递质 炎症因子 

分 类 号：R969[医药卫生—药理学]