胡义亭++++++张建++++++贾桂丛++++++侯洪涛++++++苏少慧++++++白云++++++王玉珍

[摘要] 目的 探討黛力新在炎症性肠病（IBD）中的治疗效果及作用机制。 方法 回顾性分析河北省人民医院消化科2015年9月～2017年1月收治的IBD患者60例的临床资料，按照治疗方法将其分为黛力新组、对照组，每组30例。观察两组治疗前后焦虑自评量表（SAS）及抑郁自评量表（SDS）评分，并通过IBD生存质量问卷（IBDQ）评价两组患者治疗后的生存改善情况。比较两组治疗前后血中炎症指标的变化情况。 结果 黛力新组SAS、SDS评分均较治疗前明显下降（P < 0.05），且治疗后评分均明显低于对照组（P < 0.05）。对照组治疗前后SAS、SDS评分无明显改善（P > 0.05）。两组治疗后IBDQ评分均较治疗前有不同程度的升高（P < 0.05），且黛力新组治疗后IBDQ评分升高的更加明显（P < 0.05）。两组治疗后血中血小板计数（PLT）、C反应蛋白（CRP）水平均较治疗前明显降低（P < 0.05），且黛力新组治疗后血中PLT、CRP水平均明显低于对照组（P < 0.05）。 结论 抗抑郁/焦虑治疗能够明显改善IBD患者的焦虑、抑郁状态，提高生活质量，降低IBD患者机体炎症水平。

[关键词] 炎症性肠病；焦虑；抑郁；炎症；黛力新

[中图分类号] R516.1 [文献标识码] A [文章编号] 1673-7210（2017）11（b）-0133-04

[Abstract] Objective To explore the clinical effect and mechanism of Deanxit in inflammatory bowel disease （IBD）. Methods The clinical data of 60 cases of patients with IBD admitted to Department of Gastroenterology， Hebei General Hospital from September 2015 to January 2017 was analyzed retrospectively. According to the treatment， they were divided into Deanxit group and control group， with 30 patients in each group. The scores of self-rating anxiety scale （SAS） and self-rating depression scale （SDS） before and after treatment in the two groups were observed， and the survival improvement after treatment was evaluated by inflammatory bowel disease questionnaire （IBDQ）. The changes of blood inflammatory markers before and after treatment in the two groups were compared. Results After treatment， the scores of SAS and SDS in Deanxit group were significantly lower than those before treatment （P < 0.05）， which were significantly lower than those in the control group （P < 0.05）. There were no statistically significant differences of SAS and SDS within the control group before and after treatment （P > 0.05）. After treatment， the IBDQ scores in the two groups were all higher than those before treatment （P < 0.05）， and the IBDQ score in Deanxit group was increased more significantly （P < 0.05）. After treatment， the levels of platelet count （PLT） and C-reactive protein （CRP） in the two groups were all significantly lower than those before treatment （P < 0.05）， and the levels of PLT and CRP in Deanxit group were all significantly lower than those of control group （P < 0.05）. Conclusion The antidepressant / anxiety treatment can significantly improve the anxiety and depression in IBD patients， enhance the quality of life and reduce the inflammatory levels of patients with IBD.

[Key words] Inflammatory bowel disease； Anxiety； Depression； Inflammation； Deanxitendprint

炎症性肠病（IBD）是一种慢性非特异性肠道炎症性疾病，病因尚不完全清楚，具有病程长、难治愈、易复发的特点[1]。目前认为IBD属于心身疾病，发病与环境、遗传、免疫、心理等因素密切相关；患者普遍存在敏感、抑郁、焦虑等心理健康方面的问题[2]。Tribbick等[3]在研究中比较了IBD患者和健康人群的心理状态，发现与健康人群相比，IBD患者普遍存在不同程度的焦虑、抑郁心理，严重影响了患者的生存质量。据统计，全球范围内的IBD发病率呈逐年上升趋势，如何提高该疾病的治疗效果是学者们研究的热点[4]。本研究旨在探讨抗抑郁/焦虑治疗对于改善IBD心理/病理状态的意义，为IBD的综合治疗特别是心理治疗提供客观依据。

1 资料与方法

1.1 一般资料

选择河北省人民医院（以下简称“我院”）消化科2015年9月～2017年1月收治的IBD患者60例为研究对象。……