米氮平在难治性腹泻型肠易激综合征治疗中的应用

发布时间：2019-06-06 04:39

【摘要】：目的探讨米氮平联合奥替溴铵及复合乳酸杆菌治疗难治性腹泻型肠易激综合征(RIBS-D)的临床疗效。方法选择RIBS-D患者82例,随机分为实验组43例及对照组39例。两组均服用奥替溴铵40 mg及复合乳酸菌胶囊420 mg,均服用3次/d。实验组每晚睡前口服米氮平片,起始剂量为10 mg/d,3 d后增加至15 mg/d,1周内增加至30 mg/d。对照组加服安慰剂维生素C片50 mg每晚睡前口服。治疗4周后评价临床疗效;治疗前及治疗4周后应用医院焦虑抑郁量表(HADS)评估精神心理状态,应用生活质量评价量表(QOL)评估生活质量;治疗4周后观察不良反应发生情况。结果实验组、对照组总有效率分别为95.35%、12.82%,实验组总有效率高于对照组(P0.01)。实验组治疗后HADS焦虑、抑郁评分均低于对照组,IBS-QOL评分高于对照组(P均0.01)。结论在奥替溴铵及复合乳酸杆菌基础上,应用米氮平治疗RIBS-D疗效好,可能与改善患者的精神症状有关。
[Abstract]:Objective to investigate the clinical efficacy of mirtazapine combined with oxonium bromide and Lactobacillus in the treatment of refractory diarrhea irritable bowel syndrome (RIBS-D). Methods 82 patients with RIBS-D were randomly divided into experimental group (n = 43) and control group (n = 39). Both groups were given Otionium bromide 40 mg and compound lactic acid bacteria capsule 420 mg, for 3 times / d. The experimental group was given mirtazapine tablets every night before bedtime, and the initial dose was increased to 30 mg/d. within 15 mg/d,1 weeks after the initial dose was 10 mg/d,1 d. The control group was given placebo and vitamin C tablets for 50 mg every night before bedtime. The clinical efficacy was evaluated after 4 weeks of treatment, the mental and psychological status was evaluated by hospital anxiety and depression scale (HADS) before and 4 weeks after treatment, and the quality of life (QOL) was evaluated by quality of life scale (QOL). The occurrence of adverse reactions was observed after 4 weeks of treatment. Results the total effective rate of the experimental group was 95.35% and that of the control group was 12.82%. The total effective rate of the experimental group was higher than that of the control group (P 0.01). After treatment, the scores of HADS anxiety and depression in the experimental group were lower than those in the control group, and the IBS-QOL scores in the experimental group were higher than those in the control group. Conclusion on the basis of oltionium bromide and combined Lactobacillus, mirtazapine is effective in the treatment of RIBS-D, which may be related to the improvement of mental symptoms.
【作者单位】：广东医学院附属厚街医院;
【基金】：广东省东莞市科技技术资助项目(201410515000435)
【分类号】：R574.4

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