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目的 调查功能性消化不良 (FD) 15 8例患者的抑郁障碍 ,为心理治疗FD提供依据。方法 以DSM -Ⅳ为标准诊断抑郁障碍 ,Zung抑郁自评量表评价其严重程度。将伴抑郁的FD分为 3组 :对照 (常规内科治疗 )、氟西汀、多虑平组 ,随访 12周 ,以FD症状计分及Zung积分减少 5 0 %或以上为治疗有效。结果 (1) 15 8例FD中 43例诊断为抑郁障碍 ,其发生率为 2 7 2 2 % ;(2 )氟西汀和多虑平治疗组的有效率分别为 80 0 0 % (12 / 15 )和 72 73% (8/ 11) ,其FD症状分和Zung积分明显下降 ,与对照组有显著性差异 (P <0 0 0 1) ;(3)氟西汀的不良反应较多虑平轻。结论 FD伴随的抑郁障碍发生率高 ,抗抑郁治疗能有效地改善抑郁和消化不良症状 ,治疗宜首选 5 -羟色胺再摄取抑制剂。
Objective To investigate the depressive disorders in 15 8 patients with functional dyspepsia (FD), and to provide basis for psychological treatment of FD. Methods DSM-Ⅳ was used to diagnose depression and Zung depression self-rating scale to evaluate its severity. FD patients with depression were divided into 3 groups: control (conventional medical treatment), fluoxetine and doxepin group, followed up for 12 weeks, scored FD symptoms and reduced Zung score 50% or more for the treatment of effective. Results (1) Of the 8 8 FD patients, 43 cases were diagnosed as depressive disorder with a rate of 2 72.2%. (2) The effective rates of fluoxetine and doxepin were 80 0% (12 / 15) and 72 73% (8/11) respectively. The scores of FD and Zung decreased significantly compared with the control group (P <0.01). (3) The adverse reaction of fluoxetine was more considered Flat light. Conclusions The incidence of depression accompanied with FD is high. Antidepressant treatment can effectively improve the symptoms of depression and dyspepsia, and 5 - HT reuptake inhibitor is the first choice in treatment.