米氮平治疗腹泻型肠易激综合征疗效观察

目的：观察米氯平治疗腹泻型肠易激综合征（D—IBS）的临床疗效及安全性。方法：腹泻型肠易激综合症患者42例，口服米氮平片，起始剂量每晚10mg，3d加至15mg，1周内加至30mg，治疗4周。观察治疗前后D-IBS胃肠道症状总体评分、临床疗效总评量表（CGI）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定疗效，治疗时出现的症状量表（TESS）评定安全性。结果：39例完成8周的观察，至8周末有效率达97．4％。患者胃肠道症状评分、CGI、HAMD、HAMA评分等指标与治疗前比较，差异有统计学意义（P〈0．05）。治疗期间时不良反应主要为头晕、嗜睡、疲乏感，多出现在1周内，能自行缓解。结论：米氮平既能缓解D-IBS患者的胃肠道症状，又能改善焦虑抑郁症状，是治疗腹泻型肠易激综合征安全、有效的药物。

Observation of Curative Effect of Mirtazapine on the Treatment of Diarrhea Type Irritable Bowel Syndrome

Objectlve：To observe the efficacy and safety of mirtazapine treatment of diarrhea-predominant irritable bowel syndrome （D-IBS） of clinical. Methods ：42 cases diagnosed as diarrhea-predominant irritable bowel syndrome were orally given mirtazapine, from the starting dose of 10 mg per night, to 15 mg for the first 3 days and then to 30 mg in a week for 8 weeks. Before and after the treatment, their D-IBS gastrointestinal symptoms, clinical efficacy of overall rating scale （CGI）, Hamilton depression scale （HAMD） and Hamilton anxiety scale （HAMA） evaluation of curative effect were evaluated. The safety was evaluated by the adverse reaction scale （TESS）. Results：The efficient rate of 39 cases observed for 8 weeks reached 97.4% at the end of 8 weeks. Their gastrointestinal symptoms, CGI, HAMD and HAMA scores were compared. There were more significant differences after the treatment than before it （ P 〈 0.05 ）. The main adverse reactions as dizziness, drowsiness, fatigue appeared within 1 week, but they could be relieved by themselves. Conclusion： Mirtazapine could alleviate D-IBS patients with gastrointestinal symptoms and improve the symptoms of anxiety and depression. It is a kind of safe and effective drug with clinical significance.