Department of Gastroenterology, Guangzhou First People's Hospital, the Second Affiliated Hospital of South China University of Technology, No. 1 Panfu Road, Guangzhou, 510180, Guangdong, China.
Department of Gastroenterology, Guangzhou Nansha Central Hospital Affiliated to Guangzhou First People's Hospital, No. 105 Fengze Road East, Guangzhou, 511457, Guangdong, China.
Dig Dis Sci. 2021 Feb;66(2):521-525. doi: 10.1007/s10620-020-06191-9. Epub 2020 Mar 12.
To observe the therapeutic effect of low-dose amitriptyline (AMT) on epigastric pain syndrome (EPS) in patients with functional dyspepsia.
Sixty patients with EPS were randomly divided into the following two groups for a four-week clinical trial: routine treatment with pantoprazole (RT group) and the AMT group. The RT group was treated with 40 mg of pantoprazole once daily. The AMT group received 25 mg of AMT once daily before bedtime. The Nepean Dyspepsia Index (NDI) checklist, Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD), and Pittsburgh Sleep Quality Index (PSQI) were employed to evaluate dyspepsia symptoms, psychological distress, and sleep, respectively.
All items were similar between the two groups before treatment (0 week). After 4 weeks of treatment, the NDI-symptom checklist score as well as the severity and bothersomeness of EPS in the AMT group was significantly decreased compared with those in the RT group (p < 0.05). However, no differences were found in the frequency of NDI checklist, psychological status (HAMD/HAMA scores) of EPS, or sleep quality (PSQI score) between the two groups after treatment. In addition, the time to fall asleep was shorter in the AMT group compared with the RT group after 4 weeks of treatment (p < 0.05).
Low-dose AMT effectively improved the dyspepsia symptoms and the time to fall asleep in the EPS patients, compared with pantoprazole, although it did not reduce the psychological distress. Therefore, AMT could be considered as a good candidate for EPS treatment in the clinic.
观察小剂量阿米替林（AMT）治疗功能性消化不良（FD）患者上腹痛综合征（EPS）的疗效。
将 60 例 EPS 患者随机分为常规治疗组（RT 组）和 AMT 组，进行为期 4 周的临床试验。RT 组给予泮托拉唑 40mg 每日 1 次，AMT 组睡前给予 AMT 25mg 每日 1 次。采用 Nepean 消化不良指数（NDI）检查表、汉密尔顿焦虑/抑郁量表（HAMA/HAMD）和匹兹堡睡眠质量指数（PSQI）分别评估消化不良症状、心理困扰和睡眠质量。
治疗前（0 周）两组各项目均相似。治疗 4 周后，与 RT 组相比，AMT 组 NDI-症状检查表评分以及 EPS 的严重程度和困扰程度明显降低（p < 0.05）。然而，两组之间 NDI 检查表的频率、EPS 的心理状态（HAMD/HAMA 评分）或睡眠质量（PSQI 评分）均无差异。此外，与 RT 组相比，治疗 4 周后 AMT 组入睡时间更短（p < 0.05）。
与泮托拉唑相比，小剂量 AMT 能有效改善 EPS 患者的消化不良症状和入睡时间，但不能减轻心理困扰。因此，AMT 可考虑作为 EPS 临床治疗的候选药物。
