功能性消化不良抗抑郁治疗早期胃肠道不良反应的机制

Mechanism of gastrointestinal adverse reaction in the early antidepressant treatment of functional dyspepsia

目的探讨功能性消化不良（FD）患者抗抑郁治疗初期出现胃肠道不良反应的机制，评价抗抑郁药物在FD治疗中的安全性。方法将57例FD患者随机分为两组，研究组30例和对照组27例。前者给予SSRIs治疗，后者给予噻奈普汀治疗，于治疗后统计两组胃肠道不良反应的类型及发生率，并了解两种药物胃肠道不良反应与疗程的关系。结果研究组胃肠道不良反应发生率明显高于对照组，且多发生于治疗早期，随着治疗时间的延长，不良反应症状逐渐减轻。结论选择性5-羟色胺再摄取抑制剂（SSRIs）是一种新型的抗抑郁药，胃肠道不良反应的发生与胃肠道内环境的5-羟色胺浓度骤然增加有关，后者作用于胃肠道5-羟色胺受体亚型，引起各种胃肠道不良反应。

Objective To investigate the mechanism of gastrointestinal adverse reaction in the early antidepressant treatment of functional dyspepsia （FD） and evaluate the safety of antidepressant in the treatment of FD. Methods Fifty-seven FD patients were divided into two groups randomly, 30 eases in the study group and 27 cases in the control group. The patients in study group were given selective seroto- nin reuptake inhibitors（SSRI）, the patients in control group were given Tianeptine. The types and inci- dence of gastrointestinal adverse reaction were recorded and analyzed, meanwhile the relationship between gastrointestinal adverse reaction and the period of treatment was understanded. Results The incidence of gastrointestinal adverse reaction in the study group was obviously higher than that in the control group, and mostly happened in the earlier treatment. As the treatments going, the gastrointestinal adverse reac- tion reduced gradually. Conclusions SSRIs is a new antidepressant drug. In the treatments, sudden in- creasing of 5-TH in the gastrointestinal internal environment leads to the events of gastrointestinal adverse reaction. 5-TH effects on 5-TH receptor in the gastrointestinal tract and causes all sorts of gastrointestinal adverse reaction.