开郁消痞方联合低剂量米氮平治疗功能性消化不良伴体质量减轻临床观察

Clinical Effect of Kaiyu Xiaopi Decoction Combined with Low-dose Mirtazapine in Treatment of Functional Dyspepsia with Weight Loss

目的观察开郁消痞方联合低剂量米氮平治疗功能性消化不良(functional dyspepsia,FD)伴体质量减轻(肝胃不和型)的临床疗效。方法将64例FD伴体质量减轻患者按随机数字表法分为对照组和治疗组,每组32例。对照组给予常规治疗和米氮平,治疗组在常规治疗和低剂量米氮平治疗基础上给予开郁消痞方。比较两组治疗前后中医证候积分、体质量变化、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分和不良反应情况。结果治疗组临床疗效优于对照组(P<0.05)。两组治疗后体质量均较治疗前增加(P<0.05);治疗组体质量增加程度大于对照组(P<0.05)。两组治疗后肝胃不和证积分均较治疗前减少(P<0.05)、HAMA、HAMD评分均较治疗前显著降低(P<0.05);治疗组治疗后肝胃不和证积分和HAMA、HAMD评分降低值均显著大于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.391)。结论开郁消痞方联合低剂量米氮平治疗FD伴体质量减轻(肝胃不和型),能缓解患者不适症状,改善焦虑、抑郁状态,增加体质量。

Objective To investigate the clinical effect of Kaiyu Xiaopi Decoction combined with low-dose mirtazapine in the treatment of functional dyspepsia(FD)with weight loss(incoordination between the liver and the stomach).Methods A total of 64 patients with FD and weight loss were divided into control group and treatment group using a random number table,with 32 patients in each group.The patients in the control group were given conventional treatment and mirtazapine,and those in the treatment group were given Kaiyu Xiaopi Decoction in addition to the conventional treatment and low-dose mirtazapine.The two groups were compared in terms of traditional Chinese medicine(TCM)syndrome score,body weight,Hamilton Depression Scale(HAMD)score,and Hamilton Anxiety Scale(HAMA)score before and after treatment,as well as adverse events.Results The treatment group had a significantly better clinical outcome than the control group(P<0.05).Both groups had a significant increase in body weight after treatment(P<0.05),and the treatment group had a significantly greater increase than the control group(P<0.05).Both groups had significant reductions in the syndrome score of incoordination between the liver and the stomach,HAMA score,and HAMD score after treatment(P<0.05),and the treatment group had significantly greater reductions than the control group(P<0.05).There was no significant difference in the incidence rate of adverse events between the two groups(P>0.391).Conclusion In patients with FD and weight loss(incoordination between the liver and the stomach),Kaiyu Xiaopi Decoction combined with low-dose mirtazapine can alleviate discomforts,improve anxiety and depression,and increase body weight.