文拉法辛联合心理干预治疗躯体化障碍临床疗效对照研究

A Control Study of Venlafaxine and the Drug Combined with Mental Intervention in the Treatment of Patients with Somatization Disorder

目的评价文拉法辛联合心理干预治疗躯体化障碍患者的临床疗效和副作用。方法将符合CCMD-3诊断标准的44例躯体化障碍患者随机分为治疗组和对照组各22例。两组病例均给予文拉法辛,起始剂量75mg.d-1,1周后増至150 mg.d-1,并维持此剂量,疗程6周。治疗组同时联合心理干预治疗。采用汉密顿抑郁量表(HAMD)、不良反应量表(TESS)评定疗效及不良反应。结果经6周治疗后,治疗组显效率为86.4%,对照组为59.1%(P<0.05),两组间HAMD减分率于第2,4,6周末比较差异均有显著性或极显著性(P<0.05或P<0.01),治疗组起效明显快于对照组。两组各时间点TESS评分差异无显著性(P>0.05)。结论文拉法辛联合心理干预治疗躯体化障碍的疗效优于单用文拉法辛。

Objective To assess the clinical therapeutic effectiveness and side effects of venlafaxine combined with mental intervention in the treatment of patients with somatization disorders. Methods Forty-four patients meeting the Chinese Classification of Mental Disorders third edition（ CCMD-3 ） diagnostic criteria for somatization disorder were randomly divided into two equal groups ： the trial group and control group. Patients of both groups were treated with venlafaxine. They were given each 75 mg of the drug PO q. d. as an initial dose. The dose was increased to 150 mg · d^-1 one week later which was maintained throughout the 6 week treatment course. On the basis of the drug treatment, patients of the trial group were subjected to mental intervention. The therapeutic effectiveness and side effects were appraised with the Hamilton Depression Scale （ HAMD ） and Treatment Emergent Symptom Scale （TESS） , respectively. Results At the end of the six week treatment, the rates of excellent effectiveness in patients of the trial group and control group were 86.4% and 59.1%, respectively （P 〈 0.05 ）. The differences between the 2 groups of patients with respect to the decrease in HAMD scores at the end of the 2^nd, 4^th and 6^th week were significant or highly significant（ P 〈 0.05 or P 〈 0.01 ） . The treatment in patients of the trial group started much earlier to exert effects than that in patients of the control group. The differences between patients of the 2 groups with respect to the TESS scores were insignificant （P 〉 0.05 ）. Conclusion Venlafaxine combined with mental intervention was shown to be superior to venlafaxine alone in the treatment of somatization disorder.