文拉法辛联合匹维溴铵治疗腹泻型肠易激综合征的临床疗效研究

Clinical Efficacy Research on Treating Irritable Bowel Syndrome with Diarrhea with Venlafaxine Plus Pinaverium Bromide

目的探讨文拉法辛联合匹维溴铵治疗腹泻型肠易激综合征(IBS)的疗效、不良反应和对抑郁、焦虑状态评分的影响。方法将60例腹泻型IBS患者随机分为试验组和对照组,每组30例。试验组给予文拉法辛联合匹维溴铵治疗,对照组仅给予匹维溴铵,8周为1个疗程。分别在入组时及治疗后第1、2、4、8周末对患者进行症状评分、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分;比较两组治疗前后、同期评分及总体疗效。结果两组腹痛、腹泻评分、症状总积分和SDS、SAS评分在治疗后第1、2、4、8周末均低于治疗前,差异有统计学意义(P<0.01)。治疗后同期比较,试验组腹痛、腹泻评分、症状总积分低于对照组,差异均有统计学意义(P<0.05);试验组SDS、SAS评分低于对照组,除第1周末差异无统计学意义外,第2、4、8周末差异均有统计学意义(P<0.05)。两组总体疗效试验组优于对照组(P<0.05)。两组不良反应均较轻,差异无统计学意义(P>0.05)。结论文拉法辛联合匹维溴铵治疗腹泻型IBS的疗效显著、持久,能很好地缓解躯体症状和抑郁、焦虑状态,且安全性高,不良反应少。

Objective To explore the effects of Venlafaxine plus Pinaverium bromide therapy on irritable bowel syn- drome （IBS） with diarrhea. Methods 60 patients with IBS were randomly divided into experimental group （n =30） and con- trol group （ n = 30 ）, treated with Venlafaxine （75mg qd） plus Pinaverium bromide （50mg tid） and Pinaverium Bromide （50mg tid） for 8 weeks respectively. The symptoms of the patients were seared, as well as their depressiveness and anxiety by means of symptom rating scale, self - rating depression scale （SDS） and self - rating anxiety scale （SAS） before the therapy, at the end of 1st, 2nd, 4th and 8th week after treatment respectively. Compare the overall curative effect of the two groups before and after the treatment and at the same period of the treatment as well. Results The total scores of abdominal pain, diarrhea, con - symptom, SDS and sAs at the end of lth, 2th, 4th and 8th week after treatment were significantly decreased compared with those before treatment in each group. The difference was statistically significant （ P 〈 0. 01 ）. The total scores of abdominal pain, diarrhea, con - symptom in the experimental group were significantly decreased compared with the control group in the e0r- responding time period after treatment （P 〈 0. 05 ）. The scores of SDS and SAS in the experimental group were decreased eom- pared with the control group in the corresponding time period after treatment. The differences were very significant in the 2nd, 4th and 8th weeks （P 〈0. 05）, but wasn＇t significant in the 1st week （P 〉0. 05）. The total curative effect was better in the ex, perimental group than that in the control group, and the differences were significant by Ridit analysis （P 〈 0. 05 ）. Both groups had very slight adverse reactions without statistical significance （ P 〉 0. 05 ）. Condusion The curative effects of Venlafaxine plus Pinaverium bromide therapy in IBS with diarrhea are marked and permanent. Venlafaxine plus Pinaverium bromide therapy can be used to relieve somatizations and improve the depressive and anxious emotions with high safety and little adverse reactions.