首荟通便胶囊联合氟哌噻吨美利曲辛片治疗老年慢性功能性便秘伴有抑郁状态的疗效分析

Efficacy of Shouhui Tongbian Capsules Combined with Flupentixol and Melitracen in the Treatment of Elderly Patients with Chronic Functional Constipation Accompanied with Depression

目的:探究首荟通便胶囊联合氟哌噻吨美利曲辛片治疗老年慢性功能性便秘伴有抑郁状态的疗效。方法:选取某院2020年9月~2021年9月住院部收治的老年慢性功能性便秘伴有抑郁状态的患者90例,采用随机数字表法分为对照组和观察组,每组45例。对照组在常规治疗基础上加用开塞露、氟哌噻吨美利曲辛片治疗,观察组在对照组治疗基础上加用首荟通便胶囊,两组均连续治疗2周,随访1个月。比较两组患者治疗前后大便干结、排便间隔时间积分情况,观察两组单胺类神经递质水平及汉密尔顿抑郁量表(HAMD)评分变化,临床疗效和不良反应发生情况及远期疗效。结果:治疗后,两组患者大便干结、排便间隔时间积分均低于治疗前,且观察组低于对照组(P<0.05);去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)水平以及HAMD评分均得到改善,且观察组优于对照组(P<0.05)。治疗后,观察组患者便密改善总有效率(88.89%)高于对照组(77.78%,P<0.05);治疗期间,观察组患者不良反应总发生率(11.11%)低于对照组(17.78%,P<0.05);随访1个月后,观察组便秘复发率(13.33%)低于对照组(31.11%,P<0.05)。结论:首荟通便胶囊联合氟哌噻吨美利曲辛片治疗老年慢性功能性便秘伴有抑郁状态疗效较佳,可有效提高患者单胺类神经递质水平,缓解抑郁情绪,改善排便情况,且不良反应与复发率低,安全性良好。

Objective:To explore the efficacy of Shouhui Tongbian capsules combined with flupentixol and melitracen in the treatment of elderly patients with chronic functional constipation associated with depression.Methods:A total of 90 elderly patients with chronic functional constipation associated with depression treated at the in-patient department of our hospital from September 2020 to September 2021 were divided into the control group and observation group by random number table,with 45 patients in each group.Patients in the control group was provided with glycerol enema,flupentixol and melitracen in addition to the conventional treatment and those in the observation group was provided with Shouhui Tongbian capsules in addition to the treatment given in the control group during the 2-week treatment and followed up for 1 month.The on-treatment clinical response,the scores of fecal impaction and defecation interval before and after the treatment,the monoamine neurotransmitter level,changes in the Hamilton depression scale(HAMD)adverse reactions,and long-term efficacy were observed and analyzed in two groups.Results:The scores of fecal impaction and defecation interval in both groups were lower than those before treatment,and lower in the observation group compared with the control group(P<0.05).The levels of norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT)and the HAMD scores were improved in both groups,and better in the observation group compared with the control group(P<0.05).After treatment,the overall response rate regarding constipation improvement in the observation group(88.89%)was higher than that in the control group(77.78%,P<0.05).During the treatment,the total incidence of adverse reactions in the observation group(11.11%)was lower than that in the control group(17.8%,P<0.05).After 1-month follow-up,the recurrence rate in the observation group(13.33%)was lower than that in the control group(31.11%,P<0.05).Conclusion:Shouhui Tongbian capsules combined with flupentixol and melitracen has favorable efficacy in the treatment of elderly patients with chronic functional constipation accompanied with depression,as demonstrated by effectively improved levels of neurotransmitters,relieved depression,improved defecation,and low adverse reaction and recurrence rates,indicating satisfactory safety.