盐酸帕罗西汀辅助治疗老年溃疡性结肠炎伴焦虑抑郁40例

Forty Cases of Adjuvant Therapy for Elderly Patients with Ulcerative Colitis Assciated with Anxiety / Depression by Paroxetine Hydrochloride

目的观察盐酸帕罗西汀辅助治疗老年溃疡性结肠炎(UC)伴焦虑/抑郁的疗效。方法将80例老年UC伴焦虑/抑郁患者采用随机数字表法随机分为治疗组及对照组各40例,对照组轻度UC患者给予美沙拉嗪肠溶片1 g,tid,po;中度UC患者给予美沙拉嗪肠溶片1 g,qid,po。足量治疗2周效果较差者加用醋酸泼尼松片10 mg,qid,po;治疗组在对照组基础上加用盐酸帕罗西汀片,起始10 mg·d-1,3 d后增加至20 mg·d-1,疗程2个月。治疗期间禁饮酒、咖啡及辛辣刺激性食物;每2周复诊1次。治疗前后对每例患者行UC临床及肠镜表现Mayo综合评分、汉密尔顿焦虑/抑郁(HAMA/HAMD)评分测试,比较治疗后的改善情况。结果治疗组治疗后Mayo综合评分较对照组显著下降,改善总有效率明显高于对照组(P<0.05);治疗组治疗后HAMA、HAMD评分均较对照组明显降低(均P<0.01)。结论帕罗西汀辅助治疗老年UC伴焦虑/抑郁,临床和肠镜综合表现以及焦虑/抑郁均有明显改善。

Objective To investigate the efficacy of paroxetine hydrochloride on elderly ulcerative colitis with anxiety /depression as adjuvant treatment. Methods The total of 80 cases of elderly ulcerative colitis with anxiety / depression were randomly assigned to the treatment and control groups （ n= 40 cases） . The mild or moderate UC patients in the control group were treated with mesalazine enteric coated tablets 1 g,tid,po or 1 g,qid,po, respectively;upon the complete treatment for 2 weeks, the patients with lower response were added with prednisone acetate tablets 10 mg,qid,po;and the patients in the treatment group were treated with paroxetine hydrochloride tablets starting from 10 mg·d-1 to 20 mg·d-1 3 days later, for 2 months in addition to the basic treatment as those in the control group. No alcohol, no coffee and no irritated foods were allowed during the treatment;regular reexamination was taken once for every 2 weeks. The clinical manifestations and colonoscopy Mayo composite score and Hamilton anxiety / depression （ HAMA/HAMD） score test were assessed for every patient before and after treatment, to detect the improvement after treatment. Results After treatment, the Mayo scores of the treatment group decreased significantly in comparison to the control group,with the total efficiency was markedly higher than that of the control group （ P〈0. 05）;HAMA and HAMD in treatment group were obviously lower than those before treatment （ both P〈0. 01）;HAMA and HAMD scores in the control group displayed no variation after treatment. Conclusion The adjuvant therapy of paroxetine hydrochloride remarkably improves the clinical and endoscopic manifestations of elderly patients with ulcerative colitis with anxiety/depression.