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目的:研究探讨枸橼酸阿尔维林联合小剂量抗抑郁药治疗难治性肠易激综合征(Irritable bowel syndrome,IBS)的临床疗效及对患者生活质量的影响。方法:选择德清县人民医院2015年1月-2017年1月期间收治的难治性IBS患者78例为研究对象,按随机数字表法均分为观察组和对照组。其中对照组采用枸橼酸阿尔维林治疗,观察组采用枸橼酸阿尔维林联合盐酸帕罗西汀治疗。治疗后对两组患者的临床疗效、不良反应及生活质量进行观察。结果:(1)观察组患者治疗后临床总有效率为94.87%(37/39),显著高于对照组为79.48%(31/39)。(2)观察组不良反应发生率为15.38%(6/39),对照组则为7.69%(3/39)。(3)两组患者治疗后的生活质量评分、症状程度评分及睡眠质量评分比较显示观察组各项评分的改善效果优于对照组患者。(4)两组患者治疗前后焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)评分比较显示,观察组治疗后SAS、SDS评分显著优于对照组患者。结论:枸橼酸阿尔维林联合小剂量抗抑郁药治疗难治性肠易激综合征临床疗效显著,能够提高患者生活质量,改善患者的睡眠质量,缓解患者抑郁焦虑症状,且用药安全性好。
Objective: To investigate the clinical efficacy of Alverine citrate combined with low-dose antidepressants in the treatment of refractory irritable bowel syndrome (IBS) and its impact on the quality of life of patients. Methods: Seventy-eight patients with refractory IBS admitted to Deqing People’s Hospital from January 2015 to January 2017 were enrolled in this study. According to random number table, 78 cases were divided into observation group and control group. The control group was treated with alverine citrate, and the observation group was treated with alverine citrate combined with paroxetine hydrochloride. After treatment, the clinical efficacy, adverse reactions and quality of life of the two groups were observed. Results: (1) The total effective rate of the observation group after treatment was 94.87% (37/39), significantly higher than that of the control group (79.48%, 31/39). (2) The incidence of adverse reactions in the observation group was 15.38% (6/39) in the observation group and 7.69% (3/39) in the control group. (3) The comparison of quality of life score, symptom score and sleep quality score after treatment showed that the improvement effect of each score of the observation group was better than that of the control group. (4) Comparison of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) between the two groups before and after treatment showed that the scores of SAS and SDS in the observation group were significantly Better than the control group patients. Conclusion: Alverine citrate combined with low-dose antidepressant has significant clinical efficacy in the treatment of refractory irritable bowel syndrome, which can improve the quality of life of patients, improve the quality of sleep and alleviate the symptoms of depression and anxiety in patients with good medication safety .