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目的 研究功能性消化不良 (FD)患者的胃排空变化规律和氟西汀对其胃排空功能、消化道症状及精神心理状态的影响。方法 给予有精神心理障碍的 1 7例运动障碍样型、1 5例溃疡样型、1 4例非特异性型FD患者氟西汀治疗 ,疗程 4周。治疗前后分别对患者进行汉密尔顿抑郁量表 (HAMD)、汉密尔顿焦虑量表 (HAMA)评分及消化道症状积分 ,并观察患者治疗前后胃排空功能变化。结果 运动障碍样型患者胃排空较正常对照组显著延缓。经氟西汀治疗 4周后 ,各型FD患者的HAMD、HAMA评分及消化道症状积分均显著降低 ,运动障碍样型患者胃排空明显加速。结论 氟西汀可能既能作用于中枢神经系统 ,改善患者精神心理状态 ,从而增强其对躯体不适的耐受性 ,又能间接加速胃排空而发挥对FD的治疗作用。
Objective To study the changes of gastric emptying in patients with functional dyspepsia (FD) and the effect of fluoxetine on gastric emptying, gastrointestinal symptoms and mental state. Methods 17 cases of dyskinesia with mental disorders, 15 cases of ulcer and 14 cases of nonspecific FD were treated with fluoxetine for 4 weeks. Before and after treatment, the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA) score and gastrointestinal symptom scores were respectively observed and the change of gastric emptying function before and after treatment was observed. Results In patients with dyskinesia, gastric emptying was significantly delayed compared with the normal control group. After 4 weeks of treatment with fluoxetine, the HAMD, HAMA score and gastrointestinal symptoms scores of all kinds of FD patients were significantly decreased, while those with dyskinesia were significantly accelerated gastric emptying. Conclusion Fluoxetine may not only act on the central nervous system, improve the mental state of patients, thereby enhancing their tolerance to physical discomfort, but also indirectly accelerate the gastric emptying and play a therapeutic effect on FD.