Objective To observe the therapeutic effects of flupentixol and melitracen tablets combined with Saccharomyces boulardii on diarrhea-predominant irritable bowel syndrome (IBS) complicated by anxiety and depression. Methods A total of 120 patients with diarrhea-predominant IBS complicated by anxiety and depression who were admitted and treated in our hospital from January 2013 to January 2015 were randomly divided into two groups, combination treatment group and control group, with 60 patients in each group. The oatients in combination treatment group were treated by flupentixol and melitracen tablets combined with oral Saccharomyces boulardii,however,the patients in control group were treated only by taking orally Sccharomyces boulardii,with a treatment course of 4 weeks for both groups. The gastrointestinal symptoms and mood disorders before treatment and on 1w,4w after treatment were observed and compsred between two groups, moreover, the incidence rates of adverse reactions were also observed and statistically analyzed. Results There was no significant difference in the effective rate of gastrointestinal symptoms improvement after 1-week treatment between control group and combination treatment group [23.3%(14/60) vs 31.7%(19/60),P>0.05]. The effective rates of Hamilton's depression scale (HAMD) scores improvement in control group and combination treatment group were 11.8%(6/51) and 33.3%(19/57),respectively,and the effective rates of symptom improvement according to Hamilton's anxiety scale (HAMA) scores in control group and combination treatment group were 16.1%(9/56) and 35.6%(21/59),respectively, there were significant differences between two groups (P <0.01). Moreover after 4-week treatment the effective rates of gastrointestinal symptoms improvement in combination treatment group patients was 93.0% (53/57),which was significantly higher than that[74.1% (43/58)] in control group(P<0.01). The effective rates of HAMD scores improvement in control group and combination treatment group were 34.7% (17/49) and 64.8%(35/54),respectively, there were significant differences between two groups(P<0.01).The effective rate of symptom improvement according to HAMA scores in combination group was 80.4%(45/56),which was significantly higher than that [35.2%(19/54)] in control group (P<0.01). After 1-week treatment,the incidence rate of adverse reactions was 5.0%(3/60)in both groups,and after 4-week treatment, the incidence rates of adverse reactions in combination treatment group and control group were 3.5%(2/57)and 3.4%(2/58),respectively,there were no significant differences in incidence rates of adverse reactions in the two time points between two groups (P>0.05).Conclusion Flupentixol and melitracen combined with saccharomyces boulardii treatment could not only improve the anxiety and depression symptoms of patients with diarrhea predominant IBS,but also effectively improve gastrointestinal symptoms of the patients. The efficient of combined treatment is better than monotherapy saccharomyces boulardii alone treatment.%目的 观察氟哌噻吨美利曲辛联合布拉酵母菌治疗伴有焦虑抑郁症状的腹泻型肠易激综合征(irritable bowel syndrome,IBS)患者的临床效果观察.方法 选择2013年1月至2015年1月住院治疗的伴有焦虑抑郁症状的腹泻型IBS患者病例共120例,分为联合治疗组和对照组,每组60例.联合治疗组用氟哌噻吨美利曲辛加口服布拉酵母菌,对照组仅口服布拉酵母菌,疗程4周.治疗前、治疗1周后、治疗4周后比较评估2组患者胃肠道症状和情绪障碍,同时观察2组患者不良症状.结果 治疗1周后,对照组和联合治疗组患者的胃肠道症状改善有效率分别为23.3%(14/60)和31.7%(19/60),差异无统计学意义(P>0.05),汉密尔顿抑郁量表(Hamilton's depression scale, HAMD)评分改善的有效率分别为11.8%(6/51)和33.3%(19/57),汉密尔顿焦虑量表(Hamilton's anxiety scale, HAMA)评分中症状改善的有效率分别为16.1%(9/56)和35.6%(21/59),差异有统计学意义.治疗4周后,联合治疗组和对照组胃肠道症状改善有效率分别为93.0%(53/57)和74.1%(43/58), HAMD 评分改善有效率分别为64.8%(35/54)和34.7%(17/49);HAMA评分中症状改善有效率分别为80.4%(45/56)和35.2%(19/54),差异均有统计学意义(χ2=5.679,P=0.017;χ2=23.056,P<0.01).治疗1周后,联合治疗组和对照组患者不良症状发生率为5.0%(3/60),治疗4周后,联合治疗组和对照组患者不良症状发生率分别为3.5%(2/57)和3.4%(2/58).2组不良症状发生率差异无统计学意义(P>0.05).结论 氟哌噻吨美利曲辛与布拉酵母菌联合治疗不仅可有效改善腹泻型IBS患者的焦虑抑郁症状,同时能够有效改善患者的消化道症状,其治疗效果明显优于单用布拉酵母菌进行治疗.
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