氟伏沙明治疗躯体形式障碍对照研究

A control study of fluvoxamine in the treatment of somatoform disorders

目的探讨氟伏沙明治疗躯体形式障碍的临床疗效及安全性。方法将179例躯体形式障碍患者随机分为两组，研究组147例，口服氟伏沙明治疗；对照组32例，口服阿米替林治疗，观察6周。于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组汉密顿抑郁量表、汉密顿焦虑量表评分均较治疗前有显著下降（P〈0．01），研究组治疗1周、2周末均较对照组下降显著（P〈0．01）；治疗6周末，研究组总有效率89．4％，对照组为81．3％，两组总有效率差异无显著性（Х^2=1．508，P〉0．05）。研究组植物神经、心血管、神经系统的不良反应发生率及副反应量表评分均显著低于对照组（P〈0．05或0．01）。结论氟伏沙明治疗躯体形式障碍总体疗效显著，较阿米替林起效快、安全性高，依从性好。

Objective To explore the clinical efficacy and safety of fluvoxamine in the treatment of somatoform disorders. Methods 179 patients with somatoform disorder were randomly divided into research group （n= 147） taking orally fluvoxamine and control group （n= 132） did amitriptyline for 6 weeks. Clinical efficacies were assessed with the Hamilton Depression Scale （HAMD） and the Hamilton Anxiety Scale （HAMA） adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the Ist, 2nd, 4th and 6th week. Results After treatment, scores of the HAMD and HAMA of both groups lowered more signifcantly compared with pretreatment （P〈0.01）, so did at the end of the Ist and 2nd week in the research than in the control group （P〈0.01） ; at the end of the 6th week, total effective rate was respectively 89.4% in the research and 81.3% in the control group, which showed no significant difference（Х^2= 1. 508,P〉0.05）. Incidences of autonomic nerve, cadiovascular and nervous system adverse reactions and TESS score were significantly lower in the research than in the control group （P〈0.05 or 0.01）. Conclusion Fluvoxamine has an evident total effect, takes effect more rapidly, has higher safety and better compliance compared with amitriptyline in the treatment of somatoform disorder.