中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
16期
1-3
,共3页
腹泻%腹泻型肠易激综合征%功能性腹泻%阶梯治疗
腹瀉%腹瀉型腸易激綜閤徵%功能性腹瀉%階梯治療
복사%복사형장역격종합정%공능성복사%계제치료
Diarrhea%Diarrhea-predominant irritable bowel syndrome%Functional diarrhea%Stepped treatment
目的对腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome, D-IBS)和功能性腹泻的腹泻情况进行程度分级,并按分级程度进行阶梯治疗,观察疗效。方法选取2008年6月~2013年11月本院门诊和住院患者中D-IBS和功能性腹泻病例195例,随机分为治疗组(99例)与对照组(96例),按腹泻程度分为轻、中、重三度,治疗组进行四段阶梯式治疗,对照组仅予以止泻药蒙脱石散、洛哌丁胺,并视有无上消化道功能障碍予以伊托必利等,且不加用抗抑郁剂。所有病例至少随访半年。结果阶梯式治疗效果明显优于单用药物治疗者,两组比较治疗效果差异有统计学意义(P<0.05)。结论并非每位腹泻的患者都需止泻药物治疗,相当多患者只需治疗腹泻以外的症状,仅少部分严重患者需要止泻药物和较长疗程的抗焦虑/抑郁治疗。按疾病的严重程度进行分级治疗,按主要症状进行对症治疗是治疗本病的原则。
目的對腹瀉型腸易激綜閤徵(diarrhea-predominant irritable bowel syndrome, D-IBS)和功能性腹瀉的腹瀉情況進行程度分級,併按分級程度進行階梯治療,觀察療效。方法選取2008年6月~2013年11月本院門診和住院患者中D-IBS和功能性腹瀉病例195例,隨機分為治療組(99例)與對照組(96例),按腹瀉程度分為輕、中、重三度,治療組進行四段階梯式治療,對照組僅予以止瀉藥矇脫石散、洛哌丁胺,併視有無上消化道功能障礙予以伊託必利等,且不加用抗抑鬱劑。所有病例至少隨訪半年。結果階梯式治療效果明顯優于單用藥物治療者,兩組比較治療效果差異有統計學意義(P<0.05)。結論併非每位腹瀉的患者都需止瀉藥物治療,相噹多患者隻需治療腹瀉以外的癥狀,僅少部分嚴重患者需要止瀉藥物和較長療程的抗焦慮/抑鬱治療。按疾病的嚴重程度進行分級治療,按主要癥狀進行對癥治療是治療本病的原則。
목적대복사형장역격종합정(diarrhea-predominant irritable bowel syndrome, D-IBS)화공능성복사적복사정황진행정도분급,병안분급정도진행계제치료,관찰료효。방법선취2008년6월~2013년11월본원문진화주원환자중D-IBS화공능성복사병례195례,수궤분위치료조(99례)여대조조(96례),안복사정도분위경、중、중삼도,치료조진행사단계제식치료,대조조부여이지사약몽탈석산、락고정알,병시유무상소화도공능장애여이이탁필리등,차불가용항억욱제。소유병례지소수방반년。결과계제식치료효과명현우우단용약물치료자,량조비교치료효과차이유통계학의의(P<0.05)。결론병비매위복사적환자도수지사약물치료,상당다환자지수치료복사이외적증상,부소부분엄중환자수요지사약물화교장료정적항초필/억욱치료。안질병적엄중정도진행분급치료,안주요증상진행대증치료시치료본병적원칙。
Objective To classify the severity degrees of diarrhea-predominant irritable bowel syndrome (D-IBS) and functional diarrhea and perform the stepped treatment according to the classification and observe the efficacy. Methods From June 2008 to November 2013, 195 cases of patients with D-IBS and functional diarrhea received clinical service and hospitalized in our hospital were selected and they were divided randomly into treatment group (99 cases) and control group (96 cases). They were classified into mild degree, moderate degree and severe degree according to the diarrhea severity. The escalation therapy was applied in treatment group for 4 stages, and the control group was only treated with antidiarrheal drugs such as montmorillonite powder and loperamide with itopride provided as if they had upper gastrointestinal dysfunction. And no antidepressant was added. Follow-ups were carried out for all patients for more than half a year. Results The effect of escalation therapy was obviously superior to drug therapy alone with significant difference (P<0.05). Conclusion Treatment of antidiarrheal drug is not needed by every diarrhea patient, and a great number of patients only need treatment for symptoms other than diarrhea. Just a few patients of serious degree need the treatment of antidiarrheal drug combined with longer course of anti-anxiety/depression therapy.Grading treatment according to severity classification of the disease and symptomatic treatment according to the main symptoms are the principles for treating the disease.
