诸葛群 张翼 徐文君

[摘要] 目的 探讨氟哌噻吨美利曲辛片联合多塞平对功能性腹痛的治疗效果。 方法 选取80例根据汉密顿抑郁量表（HAMD）及汉密顿焦虑量表（HAMA）评分后诊断为轻中度焦虑或抑郁的功能性腹痛患者为研究对象，随机分为治疗组40例，对照组40例。对照组患者给予雷贝拉唑、莫沙必利、匹维溴铵治疗，治疗组患者给予雷贝拉唑、莫沙必利、匹维溴铵并加用氟哌噻吨美利曲辛联合多塞平治疗。观察比较治疗第4及第8周末两组患者焦虑抑郁评分、功能性腹痛症状缓解率及腹痛症状评分。 结果 治疗第4周及8周末治疗组患者焦虑抑郁评分较对照组有明显下降，功能性腹痛各症状缓解率明显高于对照组，腹痛症状评分低于对照组，差异具有统计学意义（P<0.05）。 结论 氟哌噻吨美利曲辛联合多塞平可改善功能性腹痛患者焦虑抑郁状态，从而改善临床症状，提高其生活质量。

[关键词] 功能性腹痛；氟哌噻吨美利曲辛；多塞平；焦虑抑郁

[中图分类号] R572 [文献标识码] B [文章编号] 1673-9701（2018）25-0035-03

[Abstract] Objective To investigate the efficacy of flupenthixol melitracen tablets combined with doxepin in the treatment of functional abdominal pain. Methods 80 functional abdominal pain patients diagnosed with mild to moderate anxiety or depression after the HAMD and HAMA scores were selected and randomly divided into treatment group（n=40） and control group（n=40）. Patients in the control group were treated with rabeprazole， mosapride， and pinaverium bromide. Patients in the treatment group were given rabeprazole， mosapride， pinaverium bromide， and flupenthixol melitracen combined with doxepin. The anxiety and depression scores， symptomatic remission rate of functional abdominal pain， and abdominal pain symptom scores between two groups were observed and compared at the 4th and 8th weekend of treatment. Results The anxiety and depression scores were significantly decreased in the treatment group at the 4th week and the 8th week， compared with that that of the control group. The remission rate of functional abdominal pain in the observation group was significantly higher than that of the control group， and the symptom score of abdominal pain was lower than that of the control group. The difference between groups was statistically significant（P<0.05）. Conclusion Flupentixol and melitracen combined with doxepine can improve anxiety and depression in patients with functional abdominal pain， thereby improving clinical symptoms and improving their quality of life.

[Key words] Functional abdominal pain； Flupenthixol melitracen； Doxepin； Anxiety and depression

功能性腹痛綜合征（FAPS）又称慢性特发性腹痛或慢性功能性腹痛，是指持续或频繁发作的腹痛，疼痛部位多样，病程常超过半年，与胃肠道功能紊乱症状无关[1]。功能性腹痛发病机制复杂多样，目前普遍认为脑肠功能互动异常及中枢神经系统处理功能失调导致胃肠动力紊乱、内脏神经敏感性异常、肠道菌群失调，造成功能性腹痛患者产生腹痛、腹胀、反酸嗳气等多种临床症状[2，3]。大量研究发现多数功能性腹痛患者伴随抑郁、焦虑及人格变异等异常的精神状态，从而影响机体植物神经功能，造成脑-肠轴调节失衡、中枢神经调节异动，胃肠道功能感觉出现异常。……