帕罗西汀联合肠道微生态治疗对伴焦虑抑郁的老年IBS患者的效果及对其血清炎症因子和肠道菌群的影响

Paroxetine combined with intestinal microecology in the treatment of elderly IBS patients with anxiety and depression and its effect on serum inflammatory factors and intestinal flora

目的分析合并焦虑抑郁的肠易激综合征(IBS)老年患者应用肠道微生态制剂和帕罗西汀联合治疗的效果。方法随机数字表法将我院129例伴焦虑、抑郁的IBS老年患者分为2组,常规心理指导基础上,64例微生态组患者口服双歧杆菌二联活菌胶囊治疗,联合组在微生态组基础上加服盐酸帕罗西汀,均口服4周,对比各组间腹泻、腹痛消失时间、4周末肠道微生物数量、炎症因子和抑郁、焦虑状态变化和不良反应情况。结果联合组腹痛和腹泻消失快于微生态组,4周末抑郁自评量表(SDS)和焦虑自评量表(SAS)评分低于微生态组(P<0.05),双歧杆菌、乳酸杆菌和肠球菌均高于微生态组(P<0.05),两组在拟杆菌、肠杆菌、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)水平和不良反应方面无显著差异(P>0.05)。结论伴抑郁、焦虑的老年IBS患者在肠道微生态治疗基础上联合盐酸帕罗西汀,可明显改善抑郁、焦虑情绪,有利于肠道微生物及炎症状态的改善,安全有效。

Objective To analyze the effect of combined treatment of intestinal probiotics and paroxetine in elderly irritable bowel syndrome(IBS)patients with anxiety and depression.Methods 129 elderly IBS patients with anxiety and depression in our hospital were divided into 2 groups by random number table.Basised on psychological guidance,64 patients in microecological group were treated by oral bifidobacteria and live bifidobacterium capsules,The combination group added paroxetine hydrochloride,all treated for 4 weeks,and the diarrhea,abdominal pain disappearing time,number of intestinal microbes at the end of 4 weeks,inflammatory factors and depression,anxiety status changes and adverse reactions between the groups were compared.Results Abdominal pain and diarrhea disappeared faster in combined group than that in microecological group.The scores of the self-rating depression scale(SDS)and the self-rating anxiety scale(SAS)at the end of 4 weeks were lower than microecological group(P<0.05),bifidobacteria,lactic acid Bacillus and Enterococcus were higher than microecological group(P<0.05).Bacteroides,Enterobacter,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)Levels and adverse reactions were no different between the two groups(P>0.05).Conclusion The treatment of elderly IBS patients with depression and anxiety combined with paroxetine hydrochloride on the basis of intestinal microecological therapy can depress depression and anxiety,beneficial to improve intestinal microbes and inflammation safety and effectively.