肠易激综合征的优选治疗方案

Choice of the Therapeutic Measure for the Irritable Bowel Syndrome

目的 比较单用及合用匹维溴胺、阿米替林治疗肠易激综合征 (IBS)的疗效。方法 将 115例IBS病人随机分成 3组 ,匹维溴胺组 4 2例 ,其中 ,男 15例 ,女 2 7例 ,年龄 (4 1 79± 11 2 2 )岁 ,匹维溴胺 5 0mg ,3次 /d。阿米替林组 38例 ,其中 ,男 13例 ,女 2 5例 ,年龄 (4 3 19± 12 83)岁 ,阿米替林 2 5mg ,1次 /睡前。 2药合用组 ,男 12例 ,女 2 3例 ,年龄 (4 2 5 1± 11 75 )岁。观察均为 4周。结果 2药合用组总有效率 88 6 % ,优于匹维溴胺组 73 8%及阿米替林组 6 5 8% (P值均 <0 0 5 ) ,对腹痛、便秘 ,匹维溴胺疗效优于阿米替米 (P <0 0 5 ) ,对腹泻、黏液便、结肠外症状阿米替林疗效优于匹维溴胺 (P <0 0 5 )。结论 2药合用能起协同、互补的作用 。

Objective To compare the effect of the usage of pinaverium bromide and amitriptyline alone or combined with curing the irritable bowel syndrome (IBS).Methods 115 patients with IBS were divided into 3 groups randomly. There were 42 patients in the pinaverium bromide group (male 15, female 27, average age 41.79( 11.22, the dosage of 50mg. tid.), 38 patients in the amitriptyline group (male 12, female 23, average age 43.19( 12.83, the dosage of 25mg. tid.) and 35 patients in the combined therapy group (male 12, female 23, average age 42.51( 11.75). The follow-up duration was 4 weeks. Results The gross curative rate was 88.6% in the combined group, which was better than the pinaverium bromide group (73.8% P<0.05) and amitriptyline group (65.8 P<0.05). The therapeutic effects of pinaverium bromide was better than amitriptyline (P<0.05) in the IBS with bellyache and constipation. The therapeutic effect of amitriptyline was better than pinaverium bromide (P<0.05) in the ABS with diarrhea, mucous stool and the exo-colonic symptom. Conclusion Both drugs played the synergetic and complementary role while being used together and they were effective drugs in curing the IBS.