乳果糖联合氟哌噻吨/美利曲辛对伴有焦虑状态老年便秘患者的疗效观察

目的观察乳果糖联合氟哌噻吨／美利曲辛对伴有轻中度焦虑状态老年便秘患者治疗后的便秘、焦虑状态改善情况，以及不良反应的发生率。方法选择2011年1月至2012年12月在复旦大学附属华东医院门诊治疗的80例伴有轻中度焦虑状态老年便秘患者[年龄65～86（74．6±7．6）岁]，随机分为治疗组和对照组，治疗组1：3服氟哌噻吨／美利曲辛片1片，1次／d，同时给予乳果糖口服液15ml，2次／d；对照组单纯给予乳果糖口服液15ml，2次／d，疗程均为4周。分别在第2周和第4周记录患者便秘治疗的有效率以及焦虑自评量表（SAS）评分变化情况。结果两组患者在治疗4周后便秘状况均得到改善，但在治疗2周时，治疗组患者的总有效率高于对照组，差异有统计学意义（P=0．029）；治疗2周和4周时，治疗组患者的SAS评分降低值与对照组比较，差异均具有统计学意义（P=0．020，P=0．012）。两组患者均未出现严重不良反应，两组间不良反应发生率差异无统计学意义（P〉0．05）。结论乳果糖合并氟哌噻吨／美利曲辛治疗伴有轻中度焦虑状态的功能性便秘老年患者是有效且安全的。

Effect of flupentixol/melitracen combined with lactulose on treatment of constipation in the elderly with anxiety

Objective To observe the effect and adverse reactions of flupentixol/melitracen combined with lactulose on constipation and anxiety status in the elderly constipated patients with mild to moderate anxiety. Methods Eighty elderly constipated out-patients [aged （74.6±7.6） years] suffering from mild to moderate anxiety in our department from January 2011 to December 2012 were recruited in this study. They were randomly divided into treatment group and control group. The patients in treatment group were treated with flupenthixol melitracen tablets lqd, and lactulose 15ml bid, while the patients in control group were given lactulose 15ml bid only. The regimen of treatment lasted for 4 weeks in both groups. The effective rate and self-rating anxiety scale （SAS） score was measured and recorded at the 2nd and 4th weeks after treatment. Results The constipation symptoms were alleviated in the 2 groups at the end of treatment. The total effective rate after 2 weeks treatment was significantly higher in the treatment group than in control group （P = 0.029）. The SAS scores were decreased more significantly in the treatment group than in the control group at the 2nd and 4th week （P = 0.020, P = 0.012）. No serious adverse reaction was found in the 2 groups of patients. The incidence of adverse reactions had no statistical difference between the 2 groups （P 〉 0.05）. Conclusion Flupentixol/melitracen combined with lactulose is effective and safe in the treatment of functional constipation in the elderly patients with mild to moderate anxiety.