消痞导滞丸联合氟哌噻吨美利曲辛片治疗肝胃不和型功能性消化不良伴焦虑、抑郁46例临床观察

Clinical observation on 46 cases of functional dyspepsia with disharmony between liver and stomach type concomitant with anxiety and depression treated by Xiaopi Daozhi Wan(消痞导滞丸)combined with flupentixol and melitracen tablets

目的观察消痞导滞丸联合氟哌噻吨美利曲辛片治疗肝胃不和型功能性消化不良(FD)伴焦虑、抑郁的临床疗效。方法将91例伴焦虑、抑郁的肝胃不和型FD患者采用随机数字表法分为治疗组和对照组,对照组45例予多潘立酮片和氟哌噻吨美利曲辛片口服,治疗组46例予消痞导滞丸和氟哌噻吨美利曲辛片口服。2组均以30 d为1个疗程,1个疗程后比较2组的临床疗效、不良反应发生情况,以及治疗前后的症状积分、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分。结果治疗组总有效率为91.30%,对照组为71.11%,2组比较差异有统计学意义(P<0.05);2组治疗后餐后饱胀、早饱感、上腹痛、上腹烧灼感积分,症状总积分,HAMA、HAMD评分均明显降低,与同组治疗前比较差异有统计学意义(P<0.05),且除早饱感积分外,治疗组其他症状积分,症状总积分,HAMA、HAMD评分降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.05);2组治疗期间均无明显不良反应发生。结论消痞导滞丸联合氟哌噻吨美利曲辛片治疗肝胃不和型FD伴焦虑、抑郁临床疗效显著,可明显改善患者的临床症状,且较为安全,值得临床推广应用。

Objective To observe the clinical efficacy of Xiaopi Daozhi Wan(消痞导滞丸)combined with flupentixol and melitracen tablets in the treatment of functional dyspepsia(FD)with disharmony between liver and stomach type concomitant with anxiety and depression.Methods Ninety-one cases of FD with disharmony between liver and stomach type concomitant with anxiety and depression were divided into treatment group and control group according to random number table method,the control group with 45 cases were given domperidone tablets and flupentixol and melitracen tablets orally,while the treatment group with 46 cases were given Xiaopi Daozhi Wan and flupentixol and melitracen tablets orally.Thirty days constituted 1 course of treatment for both groups.After 1 course of treatment,the clinical efficacy,the incidence of adverse reactions,the symptom scores,Hamilton anxiety scale(HAMA)scores and Hamilton depression scale(HAMD)scores of the 2 groups before and after treatment were compared.Results The total effective rate of the treatment group was 91.30%,that of the control group was 71.11%,and the difference between the 2 groups was statistically significant(P<0.05).After treatment,the scores of postprandial satiety,early sensation of satiety,epigastric pain,epigastric burning sensation,the total symptom score,the scores of HAMA and HAMD in the 2 groups all significantly decreased,and the differences were statistically significant compared with the same groups before treatment(P<0.05).Except for early sensation of satiety score,other symptoms scores,the total symptom score,the scores of HAMA and HAMD in the treatment group decreased more significantly,and the differences were statistically significant compared with those of the control group after treatment(P<0.05).No adverse reactions occurred in the 2 groups during the treatment.Conclusion It has marked clinical efficacy to use Xiaopi Daozhi Wan combined with flupentixol and melitracen tablets in the treatment of FD with disharmony between liver and stomach type concomitant with anxiety and depression,which can markedly improve the clinical symptoms of the patients with good safety.It deserves clinical promotion and application.