顽固性功能性消化不良与情绪障碍的关系及坦度螺酮的治疗作用

Relationship between refractory functional dyspepsia and emotional disturbance and therapeutic action of tandospirone

目的:探讨顽固性功能性消化不良(RFD)与情绪障碍的关系以及坦度螺酮的治疗作用．方法:30例RFD患者作为研究组,在对症治疗的基础上加用坦度螺酮治疗6 wk,治疗前后行 HAMD和HAMA量表评分,以两量表分数之和除以2为情绪障碍评分标准;同时对功能性消化不良常见的8个症状评分．结果:同时具有抑郁焦虑者24例(80．0％),单纯抑郁者1例(3.3％),单纯焦虑5例(16．7％);治疗前与健康组HAMD,HAMA评分、两组情绪障碍评分以及临床综合疗效症状评分比较(26．1±6．2,21．8±4．1,24．0±5．6,11．3±3．6 vs 11．6±3．8,8．6±2．3,10．1±3．5,8．7±1．7,均 P<0．01),有显著差异．治疗前、后情绪障碍评分以及治疗前、后临床综合疗效症状评分比较,差异也均具有统计学意义(P<0．01)．结论:RFD患者存在不同程度情绪障碍;坦度螺酮可用于伴随情绪障碍的FD患者,尤其是经常规治疗无效的RFD患者的治疗．

AIM： To investigate the relationship between refractory functional dyspepsia （RFD） and emotional disturbance, and observe the therapeutic action of tandospirone. METHODS： Thirty patients with RFD were included in this study. Based on symptomatic treatment, tandospirone was used for 6 wk. HAMD and HAMA scores were obtained before and after treatment. Then the mean value of HAMD and HAMA scores was calculated to evaluate the disease status. Meanwhile, the eight common symptoms of functional dyspepsia were scored. RESULTS： Athymia and anxiety coexisted in 24 of 30 cases （80.0%）. Pure athymia was found in 1 case （3.3%）, and pure anxiety occurred in 5 cases （16.7%）. The HAMD and HAMA scores, as well as the mean values of them, were significantly higher in RFD patients than those in the healthycontrols （26.1±6.2, 21.8±4.1, 24.0±5.6 vs 11.6±3.8, 8.6±2.3, 10.1±3.5, all P〈0.01）. The score for the eight common symptoms of functional dyspepsia were also markedly higher than that in the controls （11.3±3.6 vs 8.7±1.7, P〈0.01）. The above scores were also significantly different before and after treatment （P〈0.01）. CONCLUSION： RFD patients have different degrees of emotional disturbance. Tandospirone can be used in the treatment of RFD.