二甲双胍联合米氮平治疗厌食症伴消化不良的临床疗效及对血清NE、5-HT和DA的影响

发布时间：2018-03-12 06:45

本文选题：二甲双胍　切入点：米氮平　出处：《世界华人消化杂志》2014年24期 　论文类型：期刊论文

【摘要】：目的:探讨二甲双胍联合米氮平治疗神经性厌食症伴消化不良患者的临床疗效.方法:将邹平县精神卫生中心就诊的100例厌食症(anorexia nervosa,AN)伴消化不良患者随机分为观察组和对照组各50例,对照组口服米氮平片,观察组在对照组基础上口服二甲双胍片;比较两组患者治疗前后空腹胃液pH变化水平,治疗后2、6、12 wk患者体质量变化、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)积分,并对患者血清去甲肾上腺素(norepinephrine,NE)、5-羟色胺(5-hydroxy tryptamine,5-HT)、多巴胺(dopamine,DA)和血糖水平进行检测.结果:治疗后两组胃液pH均明显升高,其中观察组pH升高水平显著高于对照组,两组间差异具有统计学意义(t=5.658,P=0.000).治疗2、6、12 wk后两组患者体质量均开始增加,与治疗前相比差异具有统计学意义;其中治疗6、12 wk观察组患者体质量显著低于对照组(t=4.805,4.864,P0.05).治疗后两组患者HAMD、HAMA评分显著降低,血清NE、5-HT、DA水平显著增加,与治疗前相比差异具有统计学意义(t=3.784,4.315,4.783,P0.05).治疗后观察组FPG、HbAlc、2 h PG有降低趋势,但是与治疗前和对照组相比差异无统计学意义;两组治疗后TESS评分、各不良反应发生情况相比差异无统计学意义.结论:二甲双胍联合米氮平治疗AN能够改善患者抑郁症状和食欲,且患者增重不明显,并未出现低血糖等症状,值得临床推广.
[Abstract]:Objective: To investigate the clinical effect of metformin combined with mirtazapine in the treatment of anorexia nervosa patients with dyspepsia. Methods: the Zouping County Mental Health Center for treatment of 100 cases of anorexia nervosa (anorexia nervosa, AN) patients with dyspepsia were randomly divided into observation group and control group 50 cases, control group was treated with Mirtazapine Tablets, in the observation group on the basis of oral metformin tablets; fasting gastric juice pH level was compared between two groups before and after treatment, the changes of quality of 2,6,12 wk patients after treatment, Hamilton Depression Scale (Hamilton depression scale, HAMD), Hamilton Anxiety Scale (Hamilton anxiety scale, HAMA) integral, and norepinephrine in serum (norepinephrine, NE 5- (5-hydroxy tryptamine), serotonin, dopamine (5-HT), dopamine, DA) were detected and the blood glucose level. Results: the two groups after treatment of gastric pH were significantly higher in the observation group, pH Elevated levels significantly higher than the control group, the difference was statistically significant between the two groups (t=5.658, P=0.000). The treatment of 2,6,12 wk after the mass of two groups of patients began to increase, compared with before treatment the difference was statistically significant; the treatment of 6,12 wk observation group was significantly lower in patients than the control group (t=4.805,4.864, P0.05) after the treatment. Two groups of patients HAMD, HAMA score decreased significantly, serum NE, 5-HT, DA levels were significantly increased, compared with before treatment, the difference was statistically significant (t=3.784,4.315,4.783, P0.05). The observation group after treatment, FPG, HbAlc, 2 h PG had a tendency to decrease, but before and after treatment compared with the control group there was no significant difference between the two groups; after treatment, TESS score, the incidence of adverse reactions was no significant difference. Conclusion: metformin combined with mirtazapine in the treatment of AN can improve the symptoms of depression and appetite of patients, and patients with weight gain is not obvious, does not appear low Blood sugar and other symptoms, worthy of clinical promotion.

【作者单位】：邹平县精神卫生中心;邹平县中医院;
【分类号】：R749.7

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