腹腔神经丛毁损术联合度洛西汀治疗中枢介导性腹痛综合征的疗效

Efficacy of celiac plexus destruction combined with duloxetine in the treatment of centrally mediated abdominal pain syndrome

目的 观察腹腔神经丛毁损术联合度洛西汀治疗中枢介导性腹痛综合征(CAPS)的临床疗效及安全性。方法 纳入我院收治的40例CAPS患者,将其分为观察组和对照组,对照组采用度洛西汀治疗,观察组在对照组治疗的基础上加用腹腔神经丛毁损术治疗。分别于治疗前及治疗后1周、4周、12周、24周采用症状自评量表(SCL-90)评估患者心理健康状态,采用简化McGill疼痛问卷(SF-MPQ)评估患者腹痛缓解情况,比较2组患者治疗后并发症发生率。结果 与治疗前比较,观察组治疗后1~12周SF-MPQ评分显著下降(P<0.05),治疗后24周下降极为显著(P<0.01),而对照组在治疗后12周才显著下降(P<0.05);治疗后1周、4周、12周,观察组SF-MPQ评分与对照组比较,差异无统计学意义(P>0.05),但治疗后24周观察组优于对照组(P<0.05)。2组患者治疗后12周内SCL-90评分组间比较差异无统计学意义(P>0.05),2组患者治疗后24周SCL-90评分较治疗前显著下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。2组患者并发症发生率比较差异无统计学意义(P>0.05)。结论 腹腔神经丛毁损术联合度洛西汀治疗CAPS可以快速且有效地缓解患者症状,且有良好的安全性。

Objective To observe the clinical efficacy and safety of celiac plexus destruction combined with duloxetine in the treatment of centrally mediated abdominal pain syndrome(CAPS).Methods A total of 40 CAPS patients admitted to our hospital were divided into the observation group and the control group.The control group was treated with duloxetine,and the observation group was treated with celiac plexus destruction on the basis of the control group.The mental health states of patients before treatment and 1 week,4 weeks,12 weeks,and 24 weeks after treatment were evaluated by the symptom checklist 90(SCL-90),respectively.The short-form McGill pain questionnaire(SF-MPQ)was used to evaluate the relief of abdominal pain.The incidence of complications after treatment was compared between the two groups of patients.Results Compared with before treatment,the SF-MPQ scores 1 to 12 weeks after treatment in the observation group decreased significantly(P<0.05),and the decrease was extremely significant 24 weeks after treatment(P<0.01);while the SF-MPQ score in the control group only significantly decreased 12 weeks after treatment(P<0.05).There was no statistically significant difference in the SF-MPQ scores after 1 week,4 weeks and 12 weeks of treatment between the observation group and the control group(P>0.05),but the observation group was better than the control group 24 weeks after treatment(P<0.05).There was no statistically significant difference in the SCL-90 scores within 12 weeks after treatment between the two groups(P>0.05),and the SCL-90 scores 24 weeks after treatment of the two groups decreased significantly compared with those before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Celiac plexus destruction combined with duloxetine in the treatment of CAPS can relieve the symptoms of patients quickly and effectively,and has a good safety.