舍曲林治疗儿童情绪障碍的临床观察

Clinical observation of sertraline in treatment of child emotional disorder

目的了解舍曲林在儿童情绪障碍治疗中的有效性、安全性、起效时间及有效剂量。方法对147例应用舍曲林治疗的儿童情绪障碍患儿进行回顾性分析，项目包括有效率、舍曲林用量、起效时间及不良反应。结果137例患儿遵医嘱定期复诊。治疗后2个月，有效率为80．3％（110／137），不良反应发生率为5．8％（8／137）。舍曲林有效剂量为（47．9±19．0）mg／d，起效时间为（20．4±13．2）d；儿童强迫症舍曲林有效剂量[（58．7±26．2）mg／d）]显著高于抑郁障碍[（43．6±14．0）mg／d]、广泛性焦虑障碍[（44．4±10．6）mg／d]及恐怖性焦虑障碍[（43．5±15．5）mg／d]（P值均〈0．01）；抑郁障碍起效时间[（14．0±6．1）d]较儿童强迫症[（26．6±16．3）d]、广泛性焦虑障碍[（22．3±13．9）d]和恐怖性焦虑障碍[（21．4±12．8）d]短（P值均〈0．01）。结论舍曲林是治疗儿童情绪障碍的有效药物，起效时间在2～3周，不良反应轻，多数患儿能耐受。对抑郁障碍起效较快，对儿童强迫症有效剂量较大。

Objective To explore the efficacy, safety,time of drug taking effect and therapeutic dosage of sertraline in treatment of child emotional disorder. Method One hundred and forty-seven patients with child emotional disorder were treated by sertraline and the efficacy rate, therapeutic dosage, the time of drug taking effect and adverse reaction was analyzed retrospectively. Results One hundred and thirty-seven patients were regular visited under supervision of a physician. Two months after treatment, the efficacy rate was 80.3%（110/137） and the rate of adverse reaction was 5.8%（8/137 ）. The therapeutic dosage of sertraline was （47.9 ± 19.0） mg/d. The time of drug taking effect was （20.4 ± 13.2） d. The therapeutic dosage of sertraline in obsessive-compulsive disorder [（58.7 ±26.2） mg/d] was significantly higher than that in depression[ （43.6 ± 14.0） mg/d],anxiety disorder[ （44.4 ± 10.6） mg/d] and phobia[（43.5 ± 15.5） mg/d] （P〈 0.01 ）. The time of drug taking effect in depression[ （ 14.0 ± 6.1 ） d] was significantly shorter than that in obsessive-compulsive disorder[ （26.6 ± 16.3） d,anxiety disorder [ （22.3 ± 13.9） d] and phobia [ （21.4 ± 12.8） d] （P 〈0.01）. Conclusions Sertraline is an efficient and safe medicine in treatment of child emotional disorder. Its adverse reaction is slight and most patients can tolerate. But it takes higher therapeutic dosage in obsessive-compulsive disorder and the time of drug taking effect is earlier in depression than in other disorder.