小剂量阿米替林联合聚乙二醇4000治疗便秘型肠易激综合征

Low-dose Amitriptyline Combined with Polyethylene Glycol 4000 for Constipation-predominant Irritable Bowel Syndrome

目的观察小剂量阿米替林联合聚乙二醇4000治疗便秘型肠易激综合征(C-IBS)近期临床疗效。方法 92例C-IBS患者随机分为观察组和对照组,各46例。两组均给予聚乙二醇4000口服,观察组同时每晚睡前顿服阿米替林50mg,连续治疗6周。观察两组临床疗效、症状指数、排便改善程度、精神心理状态评分(HAMA、HAMD)和不良反应发生率。结果 观察组总有效率89.1%优于对照组的69.6%(P<0.05);治疗后观察组症状程度指数、症状频率指数、HAMA、HAMD评分均明显低于对照组(P<0.05,P<0.01);治疗后观察组药物起效时间、大便形态恢复正常时间均比对照组缩短(P<0.05,P<0.01),大便形态恢复正常率高于对照组(P<0.01)。结论小剂量阿米替林与聚乙二醇4000联合应用能有效地缓解C-IBS患者临床症状,明显改善患者焦虑、抑郁状态,疗效优于单用聚乙二醇4000观察组,且患者依从性好,不良反应少。

Objective To observe the short-term clinical efficacy of low-dose amitriptyline combining with polyethylene glycol 4000 in the treatment of amitriptyline constipation-predominant irritable bowel syndrome （C-IBS）short-term. Methods Ninty-two C-IBS patients were randomly divided into two groups：observation group and control group,each having 46 cases. Two groups were given polyethylene glycol 4000,at the same time the observation group was given amitriptyline 50mg every night before bed, the treatment lasting 6 weeks. Clinical efficacy,symptom scores,defecation improvement,mental state score （HAMA,HAMD）and the incidence of adverse reactions were observed. Results The total effective rate of observation group was 89.1%,which was higher than that of control group 69.6%（P〈0.05）; after treatment symptoms after treatment index, symptom frequency index, HAMA, HAMD scores of observed group were significantly lower than that of control group（P〈0.05,P〈0.01）;drugs after treatment onset time,recovery time of stool form of observstion group were shorter than that of control group （P〈0.05,P〈0.01）;the rates of return to normal stool form of observation group was higher than that of control group （P〈0.01）. Conclusion Amitriptyline combined with polyethylene glycol 4000 can effectively alleviate the clinical symptoms of C-IBS patients,can significantly improve the condition of anxiety and depression,which has a better treatment effect on C-IBS patients than alone applies polyethylene glycol 4000,and better comphance,fewer adverse reactions.