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Clinical Observation of Tandospirone in Treating Functional Dyspepsia Patients with Anxiety
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摘要:
目的 观察坦度螺酮治疗功能性消化不良(functional dyspepsia, FD)合并焦虑状态患者的疗效和安全性 目的 2012年3月至2013年12月北京协和医院消化内科门诊就诊的31例FD合并焦虑状态患者, 既往常规治疗无效, 口服坦度螺酮10 mg/次, 3次/d, 治疗4周, 比较治疗前、治疗2周及治疗4周时FD症状积分; 比较治疗前和治疗4周时Zung焦虑、抑郁自评量表(Zung anxiety and depression self-rating scales, SAS、SDS)评分, 汉密尔顿焦虑、抑郁量表(Hamilton anxiety and depression scales, HAMA、HAMD)评分, 生活质量(SF-36)评分, 液体营养餐负荷试验的变化, 分析评价疗效, 同时观察记录不良反应 结果 治疗前、治疗2周、4周时总体症状积分分别为10.45±5.66、8.48±5.96、7.39±5.46, 治疗2周、4周时均较治疗前明显下降(P=0.002, 0.020);餐后饱胀不适和早饱两个单项症状积分在治疗2周、4周时较治疗前明显下降, 差异有统计学意义(P均 < 0.05)。SAS、HAMA及HAMD评分治疗4周较治疗前下降(P=0.028, 0.002, 0.000)。生活质量(SF-36)评分中生理功能、躯体疼痛、总体健康状况分数在治疗4周时有改善(P=0.033, 0.022, 0.041)。液体营养餐负荷试验阈值饮入量和饱足饮入量治疗前后差异无统计学意义(P=0.285, 0.532)。治疗期间有5例(16.1%)患者出现皮疹、瘙痒等不良反应, 其中1例因不良反应停药 结论 坦度螺酮治疗功能性消化不良合并焦虑患者安全有效, 可以作为常规治疗无效时的一个选择。 Abstract:Objective To observe the efficacy and safety of tandospirone in treating patients with functional dyspepsia(FD) co-morbid with anxiety. Methods Thirty-one patients diagnosed with FD co-morbid with anxiety and failed to respond to routine therapy were recruited from the outpatient clinic of gastroenterology in Peking Union Medical College Hospital during the period of March 2012 to December 2013. The patients were treated with tandospirone citrate tablets 10 mg thrice a day for 4 weeks. FD symptom scores before treatment, after 2-week treatment and after 4-week treatment were compared. The Zung anxiety and depression self-rating scales (SAS and SDS), Hamilton anxiety and depression scales (HAMA and HAMD), quality of life questionnaire (SF-36), and liquid nutrient load test results after 4-week treatments were compared with those before treatment to evaluate the efficacy of tandospirone treatment. Adverse reactions were recorded. Results The total symptom scores 2 weeks and 4 weeks after treatment were 8.48±5.96 and 7.39±5.463, both significantly lower than that prior to treatment (10.45±5.66; P=0.002, 0.020). Compared with before treatment, the discomfort after meal and early satiety symptom scores decreased significantly after 2-week and 4-week treatment (all P < 0.05). The SAS, HAMA and HAMD scores declined significantly after 4-week treatment compared with pre-treatment score (P=0.028, 0.002, 0.000). SF-36 indicated significantly improved physiological function, body pain and total health condition after 4-week treatment (P=0.033, 0.022, 0.041). The threshold volume and satiety volume in liquid nutrient load test showed no significant change after treatment (P=0.285, 0.532). During treatment, there were adverse reactions in 5 patients (16.1%, e.g. rash and pruritus) and one case withdrew from the therapy. Conclusion Tandospirone is effective and safe in treating functional dyspepsia patients with anxiety, offering an option when routine therapy fails. -
Key words:
- tandospirone /
- functional dyspepsia /
- anxiety
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表 1 功能性消化不良合并焦虑状态患者的功能性消化不良症状积分(x±s)
时间 餐后饱胀不适 早饱 上腹痛 上腹部烧灼感 总体症状 治疗前 4.35±2.60 2.70±2.89 2.48±2.13 1.06±2.03 10.45±5.66 治疗2周 3.32±2.47 1.77±2.49 2.23±2.40 1.16±1.99 8.48±5.96* 治疗4周 3.00±2.08* 1.26±2.32* 2.06±2.07 1.19±1.85 7.39±5.46* 与治疗前比较，*P＜0.05 
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表 2 功能性消化不良合并焦虑状态患者的心理量表评分(x±s)
时间 SAS SDS HAMA HAMD 治疗前 49.32±9.96 54.30±12.00 23.00±6.21 18.65±6.02 治疗4周 47.06±10.37 50.68±11.27 16.55±6.55 14.03±9.93 P值 0.028 0.369 0.002 0.000 SAS：Zung焦虑自评量表；SDS：Zung抑郁自评量表；HAMA：汉密尔顿焦虑量表；HAMD：汉密尔顿抑郁量表
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表 3 功能性消化不良合并焦虑状态患者的生活质量评分(x±s)
时间 生理功能
(physical functioning)生理职能
(physical role functioning)躯体疼痛
(bodily pain)总体健康状况
(general health)精力
(vitality)社会功能
(social role functioning)情感职能
(emotional role functioning)精神健康
(mental health)治疗前 84.19±14.03 39.52±39.67 33.33±40.37 44.03±23.85 49.35±21.49 62.50±24.79 59.68±22.32 31.77±18.60 治疗4周 89.52±10.67 56.45±39.77 56.45±39.77 57.26±22.61 53.94±20.39 70.56±23.84 70.00±20.26 38.55±20.05 P值 0.033 0.166 0.022 0.041 0.095 0.162 0.059 0.061
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[1] Drossman DA.功能性胃肠病和罗马Ⅲ的制定[M]//柯美云, 方秀才, 译.罗马Ⅲ:功能性胃十二指肠病.北京:科学出版社, 2008:372-397. [2] 张静, 孙晓红, 王志凤, 等.灌注法液体营养餐负荷试验——一种评价近端胃适应性的新方法[J].中华消化杂志, 2010, 8:518-521. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhxhzz201008004 [3] Mizuta Y, Shikuwa S, Isomoto H, et al. Recent insights into digestive motility in functional dyspepsia[J]. J Gastroenterol, 2006, 41:1025-1040. doi: 10.1007/s00535-006-1966-z [4] Keohane J, Quigley EM. Functional dyspepsia:the role of visceral hypersensitivity in its pathogenesis[J]. World J Gastroenterol, 2006, 12:2672-2676. doi: 10.3748/wjg.v12.i17.2672 [5] Ruiz García A, Gordillo López FJ, Hermosa Hernán JC, et al. Effect of the Helicobacter pylori eradication in patients with functional dyspepsia:randomized placebo-controlled trial[J]. Med Clin(Barc), 2005, 124:401-405. http://europepmc.org/abstract/MED/15799844 [6] Li Y, Nie Y, Sha W, et al. The link between psychosocial factors and functional dyspepsia:an epidemiological study[J]. Chin Med J(Engl), 2002, 115:1082-1084. http://www.zhangqiaokeyan.com/academic-journal-foreign_other_thesis/020414854567.html [7] De la Roca-Chiapas JM, Solís-Ortiz S, Fajardo-Araujo M, et al. Stress profile, coping style, anxiety, depression, and gastric emptying as predictors of functional dyspepsia:a case-control study[J]. J Psychosom Res, 2010, 68:73-81. doi: 10.1016/j.jpsychores.2009.05.013 [8] Haug TT, Withelmsenl, Ursin H, et al. What are the real 8 problems for patients with functional dyspepsia[J]. Scand J Gasteroenterol, 1995, 30:97-100. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=10.1177/0957154X9400502001 [9] 潘小平, 李瑜元, 沙卫红, 等.抗抑郁药治疗功能性消化不良的临床研究[J].中华消化杂志, 1999, 19:162-164. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhxhzz199903006 [10] Talley NJ, Herrick L, Locke GR. Antidepressants in functional dyspepsia[J]. Expert Rev Gastroenterol Hepatol, 2010, 4:5-8. doi: 10.1586/egh.09.73 [11] Jackson JL, O'Malley PG, Tomkins G, et al. Treatment of functional gastrointestinal disorders with antidepressant medications:a meta-analysis[J]. Am J Med, 2000, 108:65-72. doi: 10.1016/S0002-9343(99)00299-5 [12] Hamik A, Oksenberg D, Fischette C, et al. Analysis of tandospirone (SM-3997) interactions with neurotransmitter receptor binding sites[J]. Biol Psychiatry, 1990, 28:99-109. doi: 10.1016/0006-3223(90)90627-E [13] Coulie B, Tack J, Janssens J. Influence of buspirone-induced fundus relaxation on the perception of gastric distension in man[J]. Gastroenterology, 1997, 110:A767. http://www.researchgate.net/publication/284553406_Influence_of_buspirone-induced_fundus_relaxation_on_the_perception_of_gastric_distention_in_man [14] Kinoshita Y, Hashimoto T, Kawamura A, et al. Effects of famotidine, mosapride and tandospirone for treatment of functional dyspepsia[J]. Aliment Pharmacol Ther, 2005, 21:S37-S41. doi: 10.1111/j.1365-2036.2005.02472.x [15] Seno H, Nakase H, Chiba T. Usefulness of famotidine in functional dyspepsia patient treatment:comparison among prokinetic, acid suppression and antianxiety therapies[J]. Aliment Pharmacol Ther, 2005, 21:S32-S36. doi: 10.1111/j.1365-2036.2005.02471.x [16] Hojo M, Miwa H, Yokoyama T, et al. Treatment of functional dyspepsia with antianxiety or antidepressive agents:systematic review[J]. J Gastroenterol, 2005, 40:1036-1042. doi: 10.1007/s00535-005-1687-8 -
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