文拉法辛缓释片联合舒肝解郁胶囊治疗胃肠功能紊乱伴抑郁症69例疗效观察

Efficacy and safety of venlafaxine combined with Shugan Jieyu capsule in the treatment of gastrointestinal disorders with depression:an analysis of 69 cases

目的探讨文拉法辛缓释片联合舒肝解郁胶囊治疗胃肠功能紊乱伴抑郁症病人的疗效和安全性。方法选择2016年9月至2017年9月期间泰州市第四人民医院收治的胃肠功能紊乱伴抑郁症病人136例,按随机数字表法分为对照组(67例)和观察组(69例),对照组病人接受文拉法辛口服治疗,每次75 mg,每天1次;观察组在此基础上联合舒肝解郁胶囊口服治疗,舒肝解郁胶囊4粒/次,每天3次。两组病人均持续进行6周的治疗。比较两组病人治疗后的疗效和安全性,并进行6个月的随访调查。结果观察组病人胃肠功能紊乱治疗的总有效率94.20%,高于对照组的79.10%,差异有统计学意义(χ^2=6.748,P<0.05);治疗后,观察组各项症状积分均低于对照组;治疗后,观察组血清白细胞介素(IL) 6水平(75.2±9.7)pg/mL,抑郁评分(31.5±6.7)分,均低于对照组(81.5±11.3)pg/mL,(39.2±5.4)分,差异有统计学意义(t=3.492,7.366,均P<0.05);对照组不良反应发生率10.44%(7/67)与观察组的5.79%(4/69)比较,差异无统计学意义(χ^2=1.173,P=0.278);经6个月随访,观察组复发率1.45%(1/69)低于对照组的14.93%(10/67),差异有统计学意义(χ^2=12.083,P=0.001)。结论文拉法辛联合舒肝解郁治疗胃肠功能紊乱伴抑郁症可有效提高临床疗效,促进抑郁症恢复,降低血清IL 6水平,促进胃肠功能紊乱的改善,降低复发率,安全性高,值得推广。

Objective To investigate the efficacy and safety of venlafaxine combined with Shugan Jieyu capsule in the treatment of gastrointestinal disorders with depression.Methods A hundred and thirty six patients with gastrointestinal disorders and depres sion,treated in the Fourth People’s Hospital of Taizhou from September 2016 to September 2017.were selected and randomly as signed into control group(67 cases)and observation group(69 cases).The patients in control group were treated with venlafaxine,75 mg orally once a day,while the patients in the observation group were treated with additional Shugan Jieyu capsule,4 capsules orally three times a day.All the patients were treated for 6 weeks.The efficacy and safety of the two groups after treatment were com pared and patients were followed up for 6 months.Results The total effective rate of gastrointestinal disorders in the observation group was 94.20%,which was higher than that in the control group(79.10%)(χ^2=6.748,P<0.05).After treatment,the scores of the symptoms in the observation group were lower than those of the control group;the serum IL 6 level and the depression score in the observation group were both lower than those in the control group[(75.2±9.7)pg/mL vs.(81.5±11.3)pg/mL,(31.5±6.7)points vs.(39.2±5.4)points],and the differences were statistically significant(t=3.492,7.366,both P<0.05).There was no significant difference in the incidence of adverse reaction between the control group(10.44%,7/67)and the observation group(5.79%,4/69)(χ^2=1.173,P=0.278).After 6 months of follow up,the recurrence rate in the observation group was 1.45%(1/69),which was low er than that in the control group(14.93%,10/67),and the difference was statistically significant(χ^2=12.083,P=0.001).Conclu sion In the treatment of gastrointestinal disorders with depression,venlafaxine combined with Shugan Jieyu capsule can effective ly improve the clinical efficacy,promote the recovery of depression,reduce serum IL 6 level,improve gastrointestinal dysfunction and reduce the recurrence rate,which is safe and worthy of promotion.