5-羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍对照研究

A control study of SSRIs plus insulin in the treatment of somatoform disorder

目的探讨高选择性5-羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍的临床疗效。方法将59例躯体形式障碍患者随机分为A组30例、B组29例,两组均口服高选择性5-羟色胺再摄取抑制剂治疗,B组联合胰岛素治疗。疗程6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效。结果治疗6w末A组显效率53.33%,总有效率96.67%;B组分别为86.21%,100%;B组显效率显著高于A组(χ2=7.516,P<0.01)。两组汉密顿焦虑量表、汉密顿抑郁量表评分治疗第1w末起均较治疗前有显著下降(P<0.01),第6w末B组较A组下降显著(P<0.05)。不良反应B组除体重增加较多外,其他因子与A组无显著性差异(P>0.05)。结论高选择性5-羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍疗效显著,安全性高,依从性好。

Objective To explore the clinical efficacy of SSRIs combined with insulin in the treatment of somatoform disorder. Methods 63 patients with somatoform disorder were randomly divided into group A （n=32） orally took SSRls and B（n=31） did SSRls plus insulin for 6 weeks. Curative effects were assessed with the Hamilton Depression Scale（HAMD） and the Hamilton Anxiety Scle（HAMA） before treatment and at the ends of the lst,2nd,4th and 6th week treatment. Results At the end of the 6th week, excellence and total effectiveness rates were 53.33% and 96.67% in the group A and 86.21% and 100% in the group B respectively, the excellence rate was significantly higher in the group B than in the A（P（0.01）. Since the end of the 1st week, scores of both the HAMI） and HAMA lowered very significantly compared with pretreatment for both groups（both P〈0.01, and did continiously following the time of therapy last ing. At the end of the 6th week, those did more significantly in the group B than in the group A, and the HAMD scores had significant difference（P〈0. 05） and the HAMA no（P〉0. 05）. Weight gains in the group B were more, and there was no significant differnces in the other adverse effects between the 2 groups（P〉0.05）. Conclusion SSRIs combined with insulin has a significant curative effect, higher safety and better compliance in the treatment somatoform disorder.