匹维溴铵联合文拉法辛或团体认知行为治疗肠易激综合征的疗效

目的研究给予匹维澳铵同时合并抗抑郁药或团体认知行为治疗肠易激综合征(IBS)病人的疗效。方法将符合罗马ⅡIBS诊断标准首次诊断为IBS的103例病人按就诊编号顺序分为3组,分别给予常规治疗口服匹维溴铵,联合用药(口服匹维溴铵加文拉法辛),联合心理治疗(口服匹维溴铵加团体认知行为治疗)3种疗法。治疗前与治疗8 wk后分别进行症状学和汉密尔顿抑郁量表的评定,对比3种方法的疗效。结果(1)从症状学评定来看,3组治疗的总有效率分别为75%、94%和94%,联合用药组和联合心理治疗组与常规用药组相比较总有效率无显著差异(P>0.05);治疗前3组间肠道单项症状学的积分相比较无明显差异(P>0.05),但治疗后联合用药组、联合心理治疗组与常规用药组相比较存在着显著差异(P<0.01)。3组治疗后肠道单项症状学的积分分别和治疗前相比较明显下降,均有显著差异(P<0.05)。(2)从汉密尔顿抑郁量表的评定结果来看,3组的显效率分别为56%、75%和83%,联合用药组和联合心理治疗组与常规用药组相比较存在着显著差异(P<0.01);3组HMAD总分均值治疗后分别与治疗前相比较有显著下降(P<0.01)。治疗后3组病人的HAMD总分、各因子分均值均有显著差异(P<0.01)。结论3种治疗方法对IBS均有明显疗效;联合抗抑郁药和联合团体认知行为治疗对IBS疗效优于常规药物治疗。

Curative effects of pinaverium bromide combined with venlafaxine or cognitive-behavioral group therapy on patients with irritable bowel syndrome

AIM To investigate the curative effects of pinaverium bromide combined with antidepressive drugs or cognitive-behavioral group therapy on patients with irritable bowel syndrome(IBS).METHODS One hundred and three patients with IBS were randomly divided into conventional therapy group(oral administration of pinaverium bromide),combined with antidepressant group(oral administration of pinaverium bromide plus venlafaxine),and combined with psychotherapy group (pinaverium bromide plus cognitive- behavioral group therapy).The efficacy in each group was assessed by Semeiology and Hamiton Depression Rating Scale(HAMD)before and after 8 wk treatment.RESULTS According to the effective rate of each group(75 %,94 %,94%),there were no significant differences in the two combined therapy group compared with the eonve-ntional therapy group after 8 wk treatment(P>0.05).After 8 wk treatment there were remarkable differences in total scores and factor scores of HAMD among three groups(P<0.01).The scores of HAMD in group combined with antidepressant and group combined with psychotherapy decreased obviously compared with conventional therapy group.CONCLUSION Conventional therapy combined with venlafaxine or psychotherapy has better effects in IBS treatment compared with simple conventional therapy.