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目的 :探讨小剂量抗抑郁药—盐酸帕罗西汀与聚乙二醇 (PEG) 40 0 0联合治疗便秘型肠易激综合征 (C -IBS)的疗效。方法 :按罗马标准Ⅱ选择 46例C -IBS患者随机分 2组 ,联合组 2 3例给于盐酸帕罗西汀 (10mgqd)加PEG40 0 0 (10gbid) ,对照组 2 3例给于盐酸帕罗西汀 (10mgqd) ,疗程为 8周 ,观察比较用药前后IBS症状评估 (腹胀、腹痛、排便困难、排便不尽、食欲不振 ) ,排便频率和Bristol大便性状 ,及情绪状态评分 (汉密尔顿抑郁 焦虑量表HAMD HAMA)。结果 :在治疗前后 2组患者IBS症状评分及HAMD HAMA评分均显著减低 (P <0 0 5 ) ,二组间比较无明显差异 (P >0 0 5 )。联合组在治疗的第 1周至第 4周排便频率和大便性状的改变与对照组有显著性差异 (P <0 0 5 ) ;HAMD HAMA评分在第 1周末、第 2周末、第 3周末下降较对照组明显 ,但无统计学差异意义 (P >0 0 5 )。从第四周至治疗结束 2组间各观察指标无显著性差异。结论 :PEG40 0 0与小剂量盐酸帕罗西汀联用能快速明显缓解胃肠道症状、改善焦虑抑郁情绪状态 ,是一种治疗C -IBS的有效方法 ,值得临床推广 ,其机理有待进一步研究。
Objective: To investigate the curative effect of low dose antidepressants - paroxetine hydrochloride and polyethylene glycol (PEG) 40 0 0 in the treatment of constipated irritable bowel syndrome (C -IBS). Methods: Forty-six C-IBS patients were randomly divided into two groups according to the Roman standard Ⅱ. The combination group was given Paroxetine hydrochloride (10mgqd) plus PEG40 0 (10gbid), and the control group was given Paroxetine hydrochloride 10mgqd) for 8 weeks. Before and after treatment, IBS symptom evaluation (abdominal distention, abdominal pain, defecation, defecation, loss of appetite), defecation frequency and Bristol stool, and emotional state scores (Hamilton Depression and Anxiety Scale HAMD HAMA ). Results: Before and after treatment, IBS symptom scores and HAMD HAMA scores were significantly decreased in both groups (P <0.05). There was no significant difference between the two groups (P> 0.05). The changes of defecation frequency and stool trait in the combined group from the first week to the fourth week were significantly different from those in the control group (P <0.05). The HAMD HAMA score decreased on the first weekend, the second weekend and the third weekend The control group was obvious, but not statistically significant (P> 0.05). There was no significant difference between the two groups from the fourth week to the end of treatment. Conclusion: Combination of PEG40 0 with low dose of paroxetine hydrochloride can rapidly relieve gastrointestinal symptoms and improve anxiety and depression mood. It is an effective method to treat C-IBS and is worthy of clinical promotion. The mechanism of PEG40 0 0 remains to be further studied.