小剂量抗抑郁药盐酸帕罗西汀和匹维溴胺联合治疗肠易激综合征患者观察

Effect of paroxetine hydrochloride and pinaverium bromide therapy in patients with irritable bowel syndrome

目的比较小剂量抗抑郁药物盐酸帕罗西汀和匹维溴胺与单独应用盐酸帕罗西汀及单独应用匹维溴胺治疗肠易激综合征患者的疗效。方法将156例符合罗马(诊断标准的肠易激综合征患者随机分为3组:治疗组(简称P+P组),52例应用盐酸帕罗西汀(1次/d,口服10mg/次)加匹维溴胺(3次/d,口服50mg/次);对照组1(简称P1组),50例应用盐酸帕罗西汀;对照组2(简称P2组),54例应用匹维溴胺,疗程均为12周。结果在胃肠道症状方面,P+P组对腹痛程度和腹痛天数、腹胀程度和腹胀天数及大便次数的改善优于P1组及P2组,而在大便性状(腹泻或便秘)改善方面3组间则无差异;在精神和躯体症状方面,P+P组对焦虑及腰背痛症状的改善优于P2组,但不优于P1组,其它如抑郁、不愉快、疲惫及头痛改善方面3组间也无差异。结论小剂量盐酸帕罗西汀加匹维溴胺能明显改善肠易激综合征患者的胃肠道及部分精神和躯体症状,是肠易激综合征药物治疗的一种有效方法。

Objective Comparing the curative effect of combination of small dose antidepressant:paroxetine hydrochloride plus pinaverium bromide with that of paroxetine hydrochloride and that of pinaverium bromide for treating irritable bowel syndrome (IBS).Methods Randomizingly dividing 156 patients with IBS into three groups:Treated Groups and two Non treated Groups. 52 patients took paroxetine hydrochloride 10 mg/qd ,po and pinaverium bromide 50 mg/tid ,po( Group P+P). 50 patients took paroxetine hydrochloride 10 mg/qd ,po(Group P1).The other 54 patients took only 50mg of pinaverium bromide,po.Tid( Group P2). The period for the treatment was twelve weeks.Results Group P+P showed more significant improvement in gastrointestinal symptoms of IBS, such as the degree and duration of abdominal pain, degree and duration of abdominal distension and stool frequency(constipation or diarrhea) than the Group P1and Group P2 did. Group P+P showed more significant improvement in psychogenic and psychosomatic symptoms of IBS, such as anxiety and low back pain than P2 but not than P1.Other symptoms such as stool quality, depression, unhappiness, fatigue and headache were not much different in these three groups.Conclusion The combination of small dose paroxetine hydrochloride and pinaverium bromide can significantly improve gastrointestinal , partial psychogenic and psychosomatic symptoms of IBS and is a more effective method for treating IBS.