摘要
[目的]研究匹维溴铵、雷贝拉唑与匹维溴铵+雷贝拉唑对符合腹泻型肠易激综合征(IBS)重叠功能性消化不良(FD)患者的疗效差异,探索重叠综合征的临床治疗方法,促进对症状重叠的症状识别。[方法]搜集符合罗马Ⅳ症状标准的腹泻型IBS重叠FD患者82例,随机分为匹维溴铵组(A组,26例)、雷贝拉唑组(B组,28例)及匹维溴铵+雷贝拉唑组(C组,28例),分别给予匹维溴铵、雷贝拉唑以及匹维溴铵+雷贝拉唑治疗4周,停药1周,对治疗前、治疗期及停药期分别作IBS总体症状、FD总体症状及各分症状进行评分,比较各组间治疗后症状评分差异。[结果]A组治疗后IBS总体症状评分(88.31±47.10)与C组(81.82±42.80)比较差异无统计学意义(P=0.98),均显著低于B组(174.55±45.00)(P<0.01);(2)A组治疗后FD总体症状评分(61.33±35.14)显著高于C组(38.86±22.98),2组比较差异有统计学意义(P<0.05),与A组(75.62±34.12)比较差异无统计学意义(P=0.129);(3)对上腹痛与排便相关患者,B组治疗后上腹痛症状积分(90.00±36.51)与C组(121.30±37.2)比较差异无统计学(P=0.586),均显著低于B组(P<0.01);(4)对上腹痛与排便无关患者,A组治疗后上腹痛症状评分(155.00±29.50)显著高于C组(66.67±25.82,P<0.01)和B组(253.30±46.76,P<0.01)。[结论]单独使用解痉剂对部分同时符合IBS和FD症状标准的患者有效,提示可能部分符合重叠症状标准患者实质为单纯IBS,患者上腹痛症状是否与排便相关可作为鉴别单纯IBS与重叠综合征的依据。
[Objective]To investigate the treatment effect of Pinavide,Rebaprazole and the combination of Pinavide and Rebaprazole on the patients met the diagnostic criteria of diarrhea predominant irritable bowel syndrome(D-IBS)overlap with functional dyspepsia(FD).Furtherly,to explore the treatment tactic and recognition on the symptoms overlap.[Methods]Total 82 cases met the Rome IV criteria of D-IBS overlapping with FD were involved in the study.The patients were randomly divided into Pinavide group,Rebaprazole group and the combination of Pinavide and Rebaprazole group,which were treated by the medicine for 4 weeks respectively.The baseline and recovery duration was 1 week.The overall symptoms scores of IBS,FD and the individual symptoms score,especially the upper abdominal pain,after the treatment were compared among the three groups.[Results](1)The general IBS symptoms score after the treatment in Pinavide group and the combination of Pinavide and Rebaprazole group was 88.31±47.10 and 81.82±42.80 respectively,which were all significantly lower than that in Rebaprazole group(174.55±45.00,P<0.01).(2)The general FD symptoms score after the treatment in Pinavide group(61.33±35.14)was significantly higher than that in the combination of Pinavide and Rebaprazole group(38.86±22.98,P<0.05)and was not different from that in Rebaprazole group(75.62±34.12,P=0.129).(3)In the patients with the symptoms with upper abdominal pain associated with defecation,the upper abdominal pain symptom score after the treatment in the Pinavide group and the combination of Pinavide and Rebaprazole group were all significantly lower than that in the Rebeprazole group(P<0.01).(4)In the patients with the upper abdominal pain not associated with defecation,the upper abdominal pain symptom score after the treatment in Pinavide group was significantly higher than that in the combination of Pinavide and Rebaprazole group and Rebaprazole group(P<0.01).[Conclusion]The result which patients with D-IBS/FD symptoms show better response to the solely tr
作者
李贻弘
苏青
刘劲松
熊首先
张宏
LI Yi-hong;SU Qing;LIU Jin-song;XIONG Shou-xian;ZHANG Hong(Department of Gastroenterology,Hubei Jianghan Oilfield General Hospital,Affiliated to Yangtze University,433124 Qianjiang Hubei China;Department of Gastroenterology,Union Hospital of Huazhong University of Science and Technology,430022 Wuhan Hubei China)
出处
《临床消化病杂志》
CAS
2021年第6期423-427,共5页
Chinese Journal of Clinical Gastroenterology
关键词
肠易激综合征
功能性消化不良
症状重叠
irritable bowel syndrome
functional dyspepsia
symptom overlap
