米氮平与匹维溴胺联用治疗老年腹泻型肠易激综合征的临床疗效及其机制

发布时间：2018-03-06 11:15

本文选题：米氮平　切入点：匹维溴胺　出处：《中国老年学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的观察米氮平与匹维溴胺联用治疗老年腹泻型肠易激综合征(IBS-D)的临床疗效及其作用机制。方法选择2015年4月至2016年4月66例老年IBS-D患者,随机分两组各33例,其中对照组仅应用匹维溴胺单一治疗,治疗组应用米氮平联合匹维溴胺治疗,于治疗前后采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价患者的焦虑忧郁情况,并对腹痛、腹泻评分进行评价,同时治疗前后患者均采用放射免疫法检测神经肽Y水平(NPY)。结果 66例中仅7例无焦虑、抑郁症状,18例(27.3%)轻度焦虑,11例(16.7%)中度焦虑,15例(22.7%)轻度抑郁,15例(22.7%)中度抑郁。治疗后两组SAS、SDS评分和腹痛、腹泻评分均明显下降,且治疗组下降更明显(P0.05);两组治疗后NPY水平明显升高,且治疗组升高更明显(P0.05)。结论 IBS-D患者存在一定程度的焦虑忧郁症状,米氮平与匹维溴胺联合治疗能有效改善患者腹痛、腹泻情况及焦虑忧郁症状,疗效显著,可能与上调NPY有关。
[Abstract]:Objective To observe the efficacy of mirtazapine and pinaverium bromide combined with treatment of elderly patients with diarrhea predominant irritable bowel syndrome (IBS-D) clinical efficacy and mechanism. Methods from April 2015 to April 2016, 66 cases of elderly patients with IBS-D were randomly divided into two groups of 33 cases, the control group only used a single pinaverium bromide treatment, the treatment group used Mirtazapine Combined pinaverium bromide treatment before and after treatment by self rating Anxiety Scale (SAS) and self rating Depression Scale (SDS) assessment of patients with anxiety and depression, and abdominal pain, diarrhea score were evaluated before and after treatment, and patients were detected by radio immunoassay level of neuropeptide Y (NPY). Results in 66 cases only 7 patients without anxiety, depressive symptoms, 18 cases (27.3%) of 11 cases of mild anxiety, moderate anxiety (16.7%), 15 (22.7%) cases of mild depression, 15 cases (22.7%) with moderate depression. The two groups after treatment SAS, SDS score and abdominal pain, diarrhea score were significantly decreased, and the treatment group Fall is more obvious (P0.05); NPY was significantly increased in two groups after treatment, and the treatment group was significantly higher (P0.05). Conclusion the IBS-D patients have some degree of anxiety and depression symptoms, mirtazapine and pinaverium bromide combined therapy can effectively improve the patients with abdominal pain, diarrhea and anxiety depression symptoms, obvious curative effect, and may be related to the regulation of NPY.

【作者单位】：上海市同仁医院老年科;
【基金】：上海市卫生局科研立项课题(No.20134321)
【分类号】：R574.4

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