的近期疗效观察

袁荭  渠秉（上海第二医科大学附属瑞金医院药剂科

                                    上海200025）

摘  要  目的：探讨选择性5-羟色胺再摄取抑制剂（SSRIs）氟西汀治疗伴有情绪障碍表现的肠易激综合征（IBS）患者的近期疗效，观察此类患者腹部症状与精神症状的相互关系。方法：40例伴有情绪障碍表现的肠易激综合征患者口服氟西汀8周，治疗前后分别对患者进行汉密尔顿抑郁量表（HAMD）和胃肠道症状计分标准（GSRS）的评估，观察疗效以及2种评分之间的相互关系。结果：有2例患者因出现不良反应退出研究，其余38例患者用药后的精神抑郁症状与腹部症状均有明显改善，治疗前后的HAMD和GSRS之间均存在显著差异（p<0.05）。而且HAMD与GSRS之间存在相关性（相关系数=0.65），表明肠易激综合征患者的腹部症状与情绪障碍之间存在一定相关性。结论：氟西汀对改善伴有情绪障碍的肠易激综合征患者的腹部症状及抑郁症状均有效果，提示抗抑郁治疗对此类患者有效。

关键词  肠易激综合征；情绪障碍；氟西汀

The Short-term Effect of Fluoxetine in Treating Irritable Bowel Syndrome (IBS) with Depression

[Background] Aims: To investigate the short-term effect of Fluoxetine, a selective serotonin reuptake inhibitor (SSIR), in treating irritable bowel syndrome (IBS) with depression. And to observe the relationship between patients’ abdominal symptoms and mood score. Methods: 40 IBS patients with depression entered this study. Evaluate their mood scores and symptom scores respectively according to Hamilton depression scale (HAMD) and gastroenterology symptom rating scale (GSRS) before and after an 8 weeks’ treatment of Fluoxetine. Observe the relationship between the symptom releasement and the mood scores. Results: Both the depression scores and abdominal symptoms of 38 patients were significantly improved after the short-term treatment of Fluoxetine. The HAMD and GSRS scores were obviously decreased after 8 weeks (p<0.05) and there was certain relationship between these two rating scales (RR=0.65). Conclusion: Antidepression treatment is effective in improving both the abdominal symptoms and mood status in IBS patients with depression.

[Key words]  Irritable bowel syndrome; Depression; Fluoxetine