Wang Qian-Qian, Cheng Li, Wu Bi-Yu, Qiu Hong-Yi, Xu Ping, Wang Bo, Yan Xiu-Juan, Chen Sheng-Liang
Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Neurogastroenterol Motil. 2023 Jul 30;29(3):360-369. doi: 10.5056/jnm22145.
BACKGROUND/AIMS: Stigma related with antidepressants is prevalent in patients with functional dyspepsia. It affects medication compliance and efficacy. Herbal medicine acquired a deep-rooted cultural identity in relieving dyspeptic symptoms in Asians. The research was designed to compare the effectiveness of Zhizhu Kuanzhong capsules (ZZKZ) versus doxepin hydrochloride (doxepin) on alleviating stigma and medication nonadherence among patients with refractory FD (rFD).
Patients with rFD from February 2021 to February 2022 were randomly allocated to receive either doxepin (n = 56) or ZZKZ (n = 57) combined with omeprazole for 4 weeks. Medication possession ratio (MPR), the disease- and medication-associated stigma were analyzed. The scales were utilized to assess dyspeptic symptoms (Leeds Dyspepsia Questionnaire) and psychological conditions (Generalized Anxiety Disorder Questionnaire and Patient Health Questionnaire).
The MPR values for ZZKZ were significantly higher than those for doxepin ( < 0.001). The stigma scores decreased in ZZKZ group while increased in doxepin group compared to baseline after treatment. The proportion of patients showing ZZKZ-associated stigma was significantly lower than doxepin-associated stigma ( < 0.001). The MPR values were negatively correlated with post-treatment stigma scores in both groups ( < 0.001). Dyspeptic symptoms and psychological condition were improved in both groups after treatment, with no significant difference on post-treatment Leeds Dyspepsia Questionnaire, Generalized Anxiety Disorder Questionnaire, or Patient Health Questionnaire scores between 2 groups.
ZZKZ is superior to doxepin in alleviating stigma and medication non-adherence, with comparable efficacy in improving dyspeptic symptoms and psychological condition of patients with rFD.
背景/目的：功能性消化不良患者中与抗抑郁药相关的污名化现象普遍存在。这会影响药物依从性和疗效。草药在缓解亚洲人消化不良症状方面具有深厚的文化认同感。本研究旨在比较枳术宽中胶囊（ZZKZ）与盐酸多塞平（多塞平）在减轻难治性功能性消化不良（rFD）患者的污名化和药物不依从性方面的有效性。
将2021年2月至2022年2月的rFD患者随机分配接受多塞平（n = 56）或ZZKZ（n = 57）联合奥美拉唑治疗4周。分析药物持有率（MPR）、疾病和药物相关污名。使用量表评估消化不良症状（利兹消化不良问卷）和心理状况（广泛性焦虑症问卷和患者健康问卷）。
ZZKZ的MPR值显著高于多塞平（<0.001）。与基线相比，治疗后ZZKZ组的污名评分降低，而多塞平组升高。显示与ZZKZ相关污名的患者比例显著低于与多塞平相关污名的患者比例（<0.001）。两组中MPR值与治疗后污名评分均呈负相关（<0.001）。两组治疗后消化不良症状和心理状况均有改善，两组间治疗后利兹消化不良问卷、广泛性焦虑症问卷或患者健康问卷评分无显著差异。
在减轻污名化和药物不依从性方面，ZZKZ优于多塞平，在改善rFD患者消化不良症状和心理状况方面疗效相当。
