抗抑郁药治疗功能性消化不良的机制

目的通过对功能性消化不良（FD）患者抗抑郁治疗疗效分析及治疗前后甲状腺激素水平测定探讨FD的发病机制。方法将52例FD患者随机分为两组，研究组30例和对照组22例。前者给予盐酸氟西汀加常规治疗，后者给予常规治疗；采用HAMD量表进行心理测评；采用评分法对消化不良症状评分；应用水负荷实验评价胃容受性舒张功能；应用化学发光法测定甲状腺激素水平。结果研究组与对照组治疗后比较及研究组自身治疗前后比较HAMD量表评分、消化道症状积分、水负荷量、差异均有统计学意义（P均〈0．01），且两组甲状腺激素异常者治疗后甲状腺激素水平差异有统计学意义（P〈0．01），甲状腺激素降低水平与HAMD评分呈正相关（r=0．73，P〈0．01）。结论对合并抑郁的FD患者应用抗抑郁药物能显著改善患者躯体和精神症状，且抗抑郁治疗可调节患者甲状腺激素水平。

Mechanism of antidepressant treatment for functional dyspepsia

Objective To explore the mechanism of functional dyspepsia（FD） , by analyzing the effectiveness of antidepressant treatment for the FD patients and measuring the thyroid hormone level before and after treatment. Methods Fifty - two FD patients were randomly divided into two groups, 30 cases in study group and 22 cases in the control group. The former was given fluoxetine hydrochloride plus conventional treatment, and the latter was given conventional treatment. Using the HAMD scale for psychological evaluation; Using a method of score for dyspepsia symptoms ; Using water loading test for the evaluation of gastric accommodation function; Using chemiluminescence to measure thyroid hormone level. Rusults The study group comparing with the control group after treatment and the study group itself before treatment comparing with after treatment, was significantly different in HAMD score, gastroin- testinal symptoms score and the maximal water intake（ all P 〈 0. 01 ）. The thyroid hormone level of the two groups was significant different after treatment in patients whose thyroid hormone level were abnormal before treatment （P 〈 0.01 ）. The decline of thyroid hormone level was positively correlated with the HAMD score （r = 0. 73,P 〈 0.01 ）. Conclusions For the patients of FD with depression, using antidepressant drug can significantly improve the physical and psychological symptoms, and antidepressant treatment can adjust the thyroid hormone level.