舒肝解郁胶囊联合多潘立酮、质子泵抑制剂治疗功能性消化不良伴轻中度抑郁

Efficacy and pharmacological mechanism of Shugan Jieyu Capsules combined with domperidone and proton pump inhibitors in the treatment of FD patients complicated with a mild to moderate depression

目的 探讨舒肝解郁胶囊联合多潘立酮、质子泵抑制剂治疗功能性消化不良(FD)伴轻中度抑郁患者的疗效及药理机制。方法 采用随机数表法将206例功能性消化不良伴轻中度抑郁患者分为对照组与观察组,各103例。对照组给予质子泵抑制剂(奥美拉唑)联合多潘立酮治疗,观察组在对照组基础上给予舒肝解郁胶囊治疗。2组均持续治疗2个月。比较2组治疗后临床疗效,治疗前后症状积分、心理状态、血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、同型半胱氨酸(Hcy)、生长抑素受体(SS)及神经肽S受体1(NPSR-1)水平变化,治疗期间安全性。结果 治疗后,观察组总有效率(96.12%,99/103)高于对照组(80.58%,83/103)(P <0.05)。与治疗前比较,治疗后,2组上腹烧灼感、上腹痛、餐后饱胀、早饱感的症状积分、焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)评分及血清Hcy、SS水平均降低,且与对照组进行比较,观察组更低;血清5-HT、NE、NPSR-1水平升高,且与对照组进行比较,观察组更高(P <0.05)。治疗期间,观察组不良反应发生率低于对照组(P <0.05)。结论 舒肝解郁胶囊联合多潘立酮、质子泵抑制剂可显著缓解功能性消化不良伴轻中度抑郁患者临床症状,促进患者心理状态改善,减少不良反应发生,提高治疗效果。

Objective To investigate the efficacy and pharmacological mechanism of Shugan Jieyu Capsules combined with domperidone and proton pump inhibitors in the treatment of functional dyspepsia(FD) patients complicated with a mild to moderate depression. Methods A total of 206 FD patients complicated with a mild to moderate depression who were admitted to our hospital from January 2017 to December 2021 were divided into the control group(group A, 103 cases) and the observation group(group B, 103 cases) by a random number table method. Group A was treated with proton pump inhibitors(omeprazole)combined with domperidone, while group B was given Shugan Jieyu Capsules on the basis of group A, both for 2 months continuously. The clinical e ffi cacy after treatment, and the symptom scores, psychological state, the levels of serum serotonin(5-HT), norepinephrine(NE), homocysteine(Hcy), somatostatin receptor(SS) and neuropeptide S receptor 1(NPSR-1) before and after treatment, and the safety during treatment were compared between the two groups. Results After treatment, the total ef fective rate of the observation group(96.12%, 99/103) was higher than that of the control group(80.58%, 83/103)(P<0.05). After treatment,the symptom scores of epigastric burning, epigastric pain, postprandial fullness, early satiety, the scores of Self-rating Anxiety Scale(SAS), Hamilton Anxiety Scale(HAMA), Self-rating Depression Scale(SDS), Hamilton Depression Scale(HAMD), and the levels of serum Hcy and SS were decreased in both groups, and the observation group was lower than the control group(P<0.05), while the levels of serum 5-HT, NE and NPSR-1 were increased in the two groups, and the observation group was higher than the control group(P<0.05). During the treatment, the incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05). Conclusion In the treatment of FD patients complicated with a mild to moderate depression, Shugan Jieyu Capsules combined with domperidone and proton pump inhibitors can signifi cantly relieve their clinical symptoms, promote the improvement of their psychological state, reduce the occurrence of adverse reactions, and improve the therapeutic effect.