文拉法辛缓释片与帕罗西汀治疗抑郁症对照研究

A control study of venlafaxine extended release vs paroxetine in depression

目的评价文拉法辛缓释片与帕罗西汀治疗抑郁症的临床疗效和安全性。方法将62例抑郁症患者随机分为两组各31例，研究组口服文拉法辛缓释片治疗，对照组口服帕罗西汀治疗，观察6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组各脱落1例，均不计入研究结果。研究组有效率为86．7％，对照组为83．3％；两组无显著性差异（χ^2=0．131，P〉0．05）。两组治疗后汉密顿抑郁量表评分均较治疗前有显著下降（P〈0．01），且随着治疗时间的延续均呈持续性下降；研究组治疗第1w末较对照组下降更显著（P〈0．05），其他时点评分两组均无显著性差异（P〉0．05）。研究组起效时间显著快于对照组（t=5．32，P〈0．01）。两组不良反应均较轻微，多发生在治疗初期，并随着治疗的延续逐渐减轻或缓解。结论文拉法辛缓释剂与帕罗西汀治疗抑郁症效果均显著，安全性高、依从性好；但文拉法辛缓释剂起效更快，值得临床推广应用。

Objective evaluated theefficacy and safety of venlafaxine extended release（XR） and paroxetine in the treatment of depression. Methods 62 depression patients were randomlr divided into two groups of 31 ones each, research group took orally venlafaxine XR and control group did paroxetine respectively for 6 weeks. Curative effects were assessed with the Hamilton Depression Scale（HAMD） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 1^st ,2^nd ,4^th and 6^th week treatment. Results After treatment,one of each group dropped out. The effective rate was respectively 86.7% in the research and 83.3% in the control group,which showed no significant difference （P〉0.05）. After treatment,the HAMD scores of both groups lowered more significantly compared with pretreatment（P〈0.01） and did continously with treatment; the HAMD score lowered more significantly in the research than in the control group at the end of the 1^st week（P〈0.05）,there were no significant differences in other timepoint scores（P〉0.05）. The research took effects faster than the control did（P〈 0.01）. Adverse reactions of both groups were mild, emerged in the initial stage of treatment mostly and eased or relieved gradually with treatment. Conclusion Both venlayaxine XR and paroxetine have evident effects,higher safety and better compliance in treating depressioncan,but the former takes effects faster and merits clinical generalization and application, treat depression well, safely and reliably, hut Wenlafaxine has quicker effect.