舍曲林和氯丙咪嗪治疗68例惊恐障碍的疗效比较

Six-month follow observation about the treatment of panic disorder with sertraline and clomipramine

目的评价舍曲林治疗惊恐障碍的疗效和安全性。方法采用随机单盲病例对照研究,为期24周,以临床判断和PASS、HAMD、HAMA量表来评定临床效果,以TESS来评定药物不良反应。结果入组68例舍曲林组36例,氯丙咪嗪组32例),舍曲林组最高剂量平均132.5±25.25mg.d-1,氯丙咪嗪组为153.62mg.d-1,临床疗效,第四周末舍曲林有效率为77.7%,氯丙咪嗪组为65.6%,两组有统计学差异(P<0.05),而二十四周末两组的有效率分别为100%和96.9%,两组无明显差异。从PASS、HAMD、HAMA量表来看舍曲林组从第二周末开始有明显下降,而氯丙咪嗪组则在第三或第四周以后才开始明显改变。从副反应来看舍曲林组总的发生率13.61%,明显低于氯丙咪嗪组的24.68%。结论舍曲林治疗惊恐障碍和氯丙咪嗪比较具有起效快,疗效好,副作用小等特点,是一种安全有效的治疗惊恐障碍药物。

OBJECTIVE To evaluate the efficacy and safety of the treatment of panic disorders with sertraline. METHODS A 24 weeks single-blind randomized study was designed. The efficacy was evaluated by clinical judgement, PASS and HAMA. The side-effect was assessed in terms of TESS. RESULTS 68 cases of panic disorder were enrolled （36 cases were in the treatment of sertraline, 32 cases were in clomipramine group）. According the judgement of clinicians, the marked improved rate was 77.75 % for sertraline and 65.6 % for clomipramine in the end of fourth week, By the end of this study, the effective rate was 100% for sertraline and 96.9% for clomipramine. There was no significant difference. The therapeutic effect was shown from the end of second week in the group of sertraline, but from the end of third or fourth week in that of clomipramine. The sertraline group had much lower incidence of side effect （13.61%） than that of clomipramine （24.68%）.CONCLUSION Sertraline is one of efficient and safe drug in treatment of panic disorder.