摘要
目的观察阿戈美拉汀联合低剂量奥氮平(AO)治疗伴抑郁、焦虑和睡眠障碍的餐后不适综合征(PDS)的疗效和安全性。方法选择2019年4月至2020年9月就诊于天津医科大学总医院伴抑郁、焦虑和睡眠障碍的PDS患者,分为AO组和氟哌噻吨美利曲辛(FM)组。AO组口服阿戈美拉汀25 mg和奥氮平1.70 mg(均1次/d),FM组口服FM 10.5 mg(1次/d),2组均同时服用伊托必利50 mg(3次/d),总治疗疗程均为8周。采用尼平消化不良指数-症状(NDIS)、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)和匹兹堡睡眠质量指数(PSQI)评分分别评估患者治疗前和治疗2、4、8周后消化道症状、抑郁、焦虑和睡眠状况。根据治疗前后消化道症状评分的变化评估疗效,并记录患者服用药物后的不良反应。采用独立样本t检验和卡方检验进行统计学分析。结果共纳入184例伴抑郁、焦虑和睡眠障碍的PDS患者,其中AO组98例,FM组86例。AO组和FM组治疗2、4、8周后NDIS、PHQ-9、GAD-7、PSQI评分均分别低于同组治疗前[AO组:(13.73±0.53)、(10.13±0.44)、(7.87±0.31)分比(27.08±0.84)分,(6.04±0.35)、(4.70±0.31)、(3.81±0.22)分比(10.04±0.50)分,(6.36±0.30)、(5.29±0.28)、(4.21±0.19)分比(10.71±0.51)分,(6.64±0.37)、(5.27±0.35)、(4.09±0.30)分比(11.14±0.42)分。FM组:(15.33±0.58)、(11.58±0.50)、(9.80±0.35)分比(25.10±0.79)分,(6.79±0.35)、(5.71±0.32)、(4.86±0.30)分比(9.11±0.46)分,(7.27±0.31)、(6.51±0.32)、(5.21±0.27)分比(9.79±0.44)分,(8.01±0.33)、(6.76±0.32)、(5.78±0.32)分比(10.44±0.32)分],差异均有统计学意义(AO组:t_(NDIS)=13.470、17.930、21.530,t_(PHQ-9)=6.488、8.991、11.300,t_(GAD-7)=7.361、9.315、11.031,t_(PSQI)=7.088、9.736、12.550。FM组:t_(NDIS)=9.921、14.400、17.640,t_(PHQ-9)=4.032、6.106、7.781,t_(GAD-7)=4.638、5.993、8.840,t_(PSQI)=5.289、8.199、10.310。P均<0.05)。AO组治疗2、4、8周后NDIS、GAD-7和PSQI评分均分别低于同期FM组[NDIS:(13.7
Objective To observe the efficacy and safety of the combination of agomelatine and low-dose olanzapine(AO)in the treatment of postprandial distress syndrome(PDS)with depression,anxiety and sleep disorders.Methods From April 2019 to September 2020,PDS patients with depression,anxiety and sleep disorders in Tianjin Medical University General Hospital were selected and divided into AO group and flupentixol-melitracen(FM)group.Patients of the AO group were given oral agomelatine 25 mg and AO 1.70 mg(both once per day),and the patients of FM group were given oral FM 10.5 mg(once per day),and all patients took itopride 50 mg(three times per day)at the same time.The total treatment course was eight weeks.Nepean dyspepsia index-symptom(NDIS),patient health questionnaire-9(PHQ-9),generalized anxiety disorder-7(GAD-7)and Pittsburgh sleep quality index(PSQI)were used to evaluate the gastrointestinal symptoms,depression,anxiety and sleep disorders before treatment and two,four and eight weeks after treatment,respectively.The efficacy was evaluated according to the changes of scores of gastrointestinal symptoms before and after treatment.The adverse effects after medication were recorded.Independent sample t test and chi-square test were used for statistical analysis.Results A total of 184 PDS patients with depression,anxiety and sleep disorders were enrolled,including 98 patients in AO group and 86 patients in FM group.At two,four and eight weeks after treatment,NDIS,PHQ-9,GAD-7 and PSQI scores of AO group and FM group were all lower than those of each group before treatment(AO group:13.73±0.53,10.13±0.44 and 7.87±0.31 vs.27.08±0.84;6.04±0.35,4.70±0.31 and 3.81±0.22 vs.10.04±0.50;6.36±0.30,5.29±0.28 and 4.21±0.19 vs.10.71±0.51;6.64±0.37,5.27±0.35 and 4.09±0.30 vs.11.14±0.42;FM group:15.33±0.58,11.58±0.50 and 9.80±0.35 vs.25.10±0.79;6.79±0.35,5.71±0.32 and 4.86±0.30 vs.9.11±0.46;7.27±0.31,6.51±0.32 and 5.21±0.27 vs.9.79±0.44;8.01±0.33,6.76±0.32 and 5.78±0.32 vs.10.44±0.32),and the differences w
作者
王欣
陈一鸣
梁凌
李莹
侯俊杰
赵威
李姝
张洁
苏帅
王玉明
王邦茂
Wang Xin;Chen Yiming;Liang Ling;Li Ying;Hou Junjie;Zhao Wei;Li Shu;Zhang Jie;Su Shuai;Wang Yuming;Wang Bangmao(Department of Gastroenterology and Hepatology,Tianjin Institute of Digestive Disease,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2021年第9期593-598,共6页
Chinese Journal of Digestion
基金
国家自然科学基金(81570489,81970477)。
关键词
餐后不适综合征
阿戈美拉汀
奥氮平
抑郁
焦虑
睡眠障碍
Postprandial distress syndrome
Agomelatine
Olanzapine
Depression
Anxiety
Sleep disorders
