舒肝解郁胶囊治疗老年消化不良伴焦虑患者效果观察

Effect of shugan jieyu capsule in elderly patients with comorbid dyspepsia and anxiety

目的探讨舒肝解郁胶囊治疗对老年消化不良伴焦虑患者效果。方法选取72例老年消化不良伴焦虑患者为研究对象,根据治疗方法不同分为观察组(37例)和对照组(35例)。对照组患者给予常规治疗,观察组患者在对照组基础上给予舒肝解郁胶囊治疗。两组患者均治疗4周。比较两组患者临床疗效、中医证候积分、胃肠激素[胃泌素(GAS)、胃动素(MLT)、血管活性肠肽(VIP)、胆囊收缩素受体(CCKR)]水平、神经递质和受体[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、焦虑程度[焦虑自评量表(SAS)、汉密顿焦虑量表(HAMA)评分]以及不良反应。结果治疗后,观察组患者临床疗效总有效率高于对照组(P<0.05)。治疗后,两组患者各项中医证候积分均低于治疗前,且观察组低于对照组(P<0.05或0.01)。治疗后,两组患者GAS、MLT、CCKR水平均高于治疗前,VIP水平低于治疗前,且观察组优于对照组(P<0.05或0.01)。治疗后,两组患者血清5-HT、NE、NPSR-1水平均高于治疗前,Hcy、SS水平均低于治疗前,且观察组优于对照组(P<0.05或0.01)。治疗后,两组患者SAS、HAMA评分均低于治疗前,且观察组低于对照组(P<0.01)。两组患者不良反应总发生率无显著差异(P>0.05)。结论舒肝解郁胶囊治疗老年消化不良伴焦虑患者效果确切,安全性较高。

Objective To explore the effect of shugan jieyu capsule treatment in elderly patients with comorbid dyspepsia and anxiety(CDA).Methods Seventy-two elderly CDA patients were selected as research objects and assigned to observation(n=37)and control group(n=35)according to different treatment methods.Controls received conventional treatment and observation group was plus shugan jieyu capsule on the basis of controls for 4 weeks.Such indexes were compared between two groups as clinical effects,TCM syndromes scores,the levels of gastrointestinal hormones(gastrin[GAS],melatonin[MLT],vasoactive intestinal peptide[VIP],cholecystokinin receptor[CCKR]),the levels of neurotransmitters and receptors(5-hydroxytryptamine[5-HT],norepinephrine[NE],homocysteinemia[Hcy],somatostatin receptor[SS],and neuropeptide S receptor 1[NPSR-1]),scores on the Self-rating Anxiety Scale(SAS)and Hamilton Anxiety Scaling(HAMA),and adverse reactions.Results After treatment,the total effective rate was higher in observation than control group(P<0.05).After treatment TCM syndromes scores in both groups lowered compared with pre-treatment and those were lower in observation than control group(P<0.05 or 0.01).After treatment GAS,MLT and CCKR levels were higher and VIP lower in both groups compared with pre-treatment,observation group was better than controls(P<0.05 or 0.01).After treatment serum 5-HT,NE and NPSR-1 levels were higher and Hcy and SS lower in both groups compared with pre-treatment,observation group was better than controls(P<0.05 or 0.01).After treatment scores on the SAS and HAMA were lower in both groups compared with pre-treatment and so were those in observation group than controls(P<0.01).Intergroup difference in overall incidence of adverse reactions wasn't statistically significant(P>0.05).Conclusion shugan jieyu capsule has a definite effect in elderly CDA patients and high safety.