功能性消化不良患者伴抑郁障碍的诊断和治疗

目的：探讨功能性不良（FD）患者的抑郁障碍及抗抑郁药对其疗效。方法：以CCMD－2－R为标准诊断抑郁障碍。将伴抑郁的FD随机分为3组：文拉法新组，多塞平组和对照组（常规内科治疗）。以治疗前，治疗2周和8周FD症状积分及Zung抑郁自评量表（SDS）积分变化评定疗效。结果：（1）FD中抑郁障碍的发生率为32．28％。（2）FD症状积分在文拉法新组和多塞平组于治疗2周时即明显减少（P＜0．05），于治疗8周时非常明显低于对照组（P＜0．05）；SDS只分在文拉法新组于治疗2周时即明显减少（P＜0．05），文拉法新组和多塞平组于治疗8周时均明显低于对照组（P＜0．05）；（3）文拉法新组不良反应明显低于多塞平组。结论：FD伴发的抑郁障碍发生率高，抗抑郁治疗能有效改善消化不良和抑郁症状，文拉法新作用迅速且优于多塞平。

Identification and Treatment of Depression in Patients with Functional Dyspepsia

Objective: To investigate the rate of depression in patients with functional dyspepsia (FD) and corresponding treatments Method:285 out-patients diagnosed as FD were assessed by two physician trained for depression assessment Depression was diagnosed by criteria of CCMD-2-R Patients with depression were divided into three groups: group A (n=28) received venlafaxine, group B (n=31) received doxepine, group C (n=26) received no antidepressant as control SDS (self-rate depression scale) and FD score were used to assess the effect of antidepressants Result:The rate of depression in our sample was 32% (92/285) Among 92 with depression, 85 consent to participate the study FD scores of both group A and group B decreased after 2 weeks treatment, and were significantly lower than that of group C at the end of 8 weeks The score of SDS in group decreased from the end of second week after treatment, and both group A and group B had significantly lower scores in SDS than group C at the end of 8 weeks Group A had fewer side effects than group B Conclusion:Depression is common in patients with FD Antidepressant can improve FD symptoms as well as depressive symptoms Venlafaxine has fewer side effects than doxepine