抗抑郁药治疗功能性消化不良的临床研究

Psychological factors in functional dyspepsia and its treatment

目的探讨精神、心理因素与功能性消化不良（ＦＤ）的关系及抗抑郁药对其的疗效。方法对２４例正常人和２４例ＦＤ患者进行汉密尔顿抑郁量表（ＨＡＭＤ）、汉密尔顿焦虑量表（ＨＡＭＡ）和症状自评量表（ＳＣＬ９０）评分；用抗抑郁药、５羟色胺再摄取抑制剂（ＳＳＲＩ）帕罗西汀（赛乐特）和盐酸氟西汀（百忧解）治疗ＦＤ患者，疗程均为８周，治疗后再行量表评分。结果三种量表（ＨＡＭＤ、ＨＡＭＡ、ＳＣＬ９０）评分对比，均显示ＦＤ患者的精神躯体症状与正常人之间差异有非常显著性（Ｐ＜０．００１），但在日夜变化和精神病理上，差异无显著性；ＦＤ患者接受抗抑郁药治疗８周后，精神和躯体症状均有明显改善。结论ＦＤ与精神心理因素相关，普遍存在抑郁和焦虑情绪，用抗抑郁药治疗能显著改善精神和躯体两方面症状。

Objective To investigate the role of psychological factors in functional dyspepsia (FD) and effect of antidepressant drugs on FD. Methods To analyze the psychological status of 24 FD patients and 24 healthy people using Hamilton Depression (HAMD), Hamilton Anxiety (HAMA) and SCL90 scales. Antidepressants were used to treat FD patients for 8 weeks, 11 cases with prozac, 13 cases received seroxat. Psychological analysis was done before and after the treatment. Results There was significant difference in somatic and psychological scores in HAMA and SCL90 scores between the two groups (P<0.001). The scores of FD patients improved significantly after 8 weeks treatment (P<0.001). Conclusion Psychological factors play a role in FD. The patients depression or anxiety commonly occurred in these patients, and antidepressants are effective in the treatment of FD for improving both somatic and psychological symptoms.