度洛西汀与阿米替林治疗伴焦虑症状肠易激综合征对照研究

目的探讨度洛西汀与阿米替林治疗伴焦虑症状肠易激综合征的临床疗效和安全性。方法将36例伴焦虑症状的肠易激综合征患者随机分为两组，每组18例，两组在消化内科常规治疗的基础上，研究组口服度洛西汀治疗，对照组口服阿米替林治疗，观察6周。于治疗前及治疗2周、4周、6周末采用汉密顿焦虑量表和生存质量量表评定临床疗效，副反应量表评定不良反应。结果两组治疗4周末起汉密顿焦虑量表总分均较治疗前显著下降（P〈0．01）；治疗6周末，研究组有效率为83．3％，对照组为77．8％，两组差异无显著性（P〉0．05）。研究组不良反应较轻微，发生率显著低于对照组（P〈0．05）。研究组生存质量量表的躯体不适感、自尊、人际交往功能、婚姻与家庭因子分均显著高于对照组（P〈0．01）。结论度洛西汀与阿米替林治疗伴焦虑症状肠易激综合征的疗效相当，但度洛西汀能显著改善肠易激综合征患者的躯体性不适症状，且起效更快、安全性高、依从性好。

A control study of duloxetine vs. amitriptyline in the treatment of irritable bowel syndrome with anxiety symptoms

Objective To explore the efficacy and safety of duloxetine vs. amitriptyling in the treatmeng of irritable bowel syndrome （IBS） with anxiety symptoms. Methods Thirty-six IBS patients with anxiety symptoms were randomly divided into two groups of 18 ones each, on the basis of conventional therapy of digestive system department, research group took orally duloxetine and control group did amitriptyling for 6 weeks. Clinical efficacies were assessed with the Hanmilton Anxiety Scale （HAMA） and the World Health Organization Quality of Life （WHOQL）, and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 2na , 4th and 6＇h week. Results Since the end of the 4th week, the HAMA total scores of both groups lowered more significantly compared with pretreat- ment （P~0.01） ; at the end of the 6th week, effective rates were respectively 83.3% in the research and 77.8% in the control group, which showed no significant differences （P〉0.05）. Adverse reactions of the research were mild and their incidences significantly lower compared with control group （P,0.05）. Such factors ＇ scores of the WHOQL were significantly higher in the research than in the control group as somat- ic discomfort, self-esteem, interpersonal communication, marriage ＆ family. Conclusion Duloxetine and amitriptyling have equivalent effects in IBS with anxiety symptoms, but the former can notably improve somatic discomfort, takes effect more rapidly and has higher safety and better compliance.