三联法治疗大学生肠易激惹综合征临床疗效观察
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[摘要] 目的:探讨丽珠肠乐胶囊、得舒特联合抗抑郁药物阿米替林三联法治疗大学生肠易激惹综合征的临床疗效。方法:将41例肠易激惹大学生患者随机分为两组,治疗组21例,用丽珠肠乐胶囊、得舒特联合抗抑郁药物阿米替林三联法治疗;对照组20例,单纯采用丽珠肠乐胶囊及得舒特治疗,4周后进行疗效评价。结果:治疗组显效14例,有效6例,无效1例,总有效率为95%,疗效优于对照组总有效率(65%)(P<0.05)。结论:采用丽珠肠乐胶囊、得舒特联合抗抑郁药物阿米替林三联法治疗大学生肠易激惹综合征的疗效确切,值得临床推广应用。
[关键词] 肠易激惹综合征;丽珠肠乐胶囊;得舒特;阿米替林;大学生
[中图分类号] R574.4 [文献标识码]A [文章编号]1673-7210(2010)06(a)-037-02
Clinical observation on triple therapy for irritable bowel syndrome in college students
ZHAO Yuanyuan
(Medical Office, Dalian Campus of Liaoning University of Traditional Chinese Medicine, Dalian 116000, China)
[Abstract] Objective: To investigate the clinical efficacy for Irritable Bowel Syndrome (IBS) of college students with Bifidobacterium Capsule, Dicetel and antidepressants of Amitriptyline. Methods: 41 IBS patients were randomly divided into two groups: therapy group (21 cases) and comparison group (20 cases). In the treatment group, patients were treated with Bifidobacterium Capsule, Dicetel and Amitriptyline; in the control group, patients were simply treated with Bifidobacterium Capsule and Dicetel. And evaluations were collected after 4 weeks. Results: In treatment group, 14 cases were excellent, 6 cases were effective, and only 1 patient was inefective, the total effective rate was up to 95%, which was much more effective than that of comparison group (65%) (P<0.05). Conclusion: Triple therapy with Bifidobacterium Capsule, Dicetel and Amitriptyline for IBS in college students is effectively feasible, it's worthy of clinical use.
[Key words] Irritable Bowel Syndrome (IBS); Bifidobacterium Capsule; Dicetel; Amitriptyline; College students
肠易激惹综合征(irritable bowel syndrome, IBS)是多因素致病的肠道功能性疾病,该病在大学生人群中较为常见,精神因素和应激因素一直被认为与肠易激惹综合征的发病有密切关系,关于其治疗,目前尚无特效药。笔者考虑到大学生IBS患者多带有焦虑情绪,而且精神压力也大,故笔者试用丽珠肠乐胶囊、得舒特联合抗抑郁药物阿米替林三联法治疗大学生肠易激惹综合征,其疗效满意,现报道如下:
1 资料与方法
1.1 一般资料
我医务室2008年3月～2010年4月诊治了IBS大学生患者41例,其诊断均符合1999年提出的IBS罗马Ⅱ诊断标准[1],而且经过血、尿、便常规,肝、肾功能,粪便细菌培养,胃镜和结肠镜及腹部B超检查等一系列检查,以排除器质性疾病。临床将41例患者随机分为两组,丽珠肠乐胶囊、得舒特联合抗抑郁药物阿米替林三联法设为治疗组,共21例,其中,男6例,女15例;平均年龄20.5岁;病程1～6个月,平均2.8个月。丽珠肠乐胶囊联合得舒特设为对照组,共20例,其中,男6例,女14例;平均年龄21.3岁;病程1～6个月,平均3.2个月。两组资料在性别、年龄、病程、精神心理状态等方面无显著性差异(P>0.05),具有可比性。
1.2 治疗方法
对照组患者均口服丽珠肠乐胶囊(每粒含双歧杆菌活菌0.5亿),每次2粒,2次/d,同时口服得舒特片50 mg,3次/d,持续4周。治疗组行如上治疗的同时加服阿米替林25 mg,2次/d,疗程4周。
1.3 疗效评定标准
笔者根据临床症状改善情况,将疗效分为显效、有效、无效来进行评定,其中,显效是指腹痛、腹泻、腹胀消失,排便次数及性状正常;有效是指症状明显好转,排便次数减少,性状正常;无效是指治疗前后腹痛、排便次数及大便性状无明显改善。总有效率=显效率+有效率。
1.4 统计学方法
采用χ2检验,P<0.05表示有显著性差异。
2 结果
治疗4周后,按疗效评定标准进行疗效评定,结果见表1。由表1可知,治疗组疗效优于对照组(P<0.05)。
3 讨论
人体内最常见的正常菌群包含双歧杆菌活菌,该菌对人体有益无害,是人体生理及健康所必需的,其功能主要包含:①维护肠道正常细菌菌群平衡,抑制病原菌的生长,故能防治胃肠道疾病;②发酵葡萄糖,产生大量乳酸菌与醋酸,降低pH和EH值,抑制致病菌生长,又有利于使肠腔保持酸性环境,从而维持正常肠蠕动[2-3]。IBS患者因并有肠道菌群失调、引起肠道运动的不正常等原因,故临床症状腹痛、腹胀、便秘或腹泻等较多见 ......
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