中高剂量文拉法辛对治疗不敏感性躯体形式障碍的疗效比较

Efficacy of middle dose and high dose of venlafaxine in the treatment of treatment non-response somatoform disorders

目的:探讨中高剂量文拉法辛对治疗不敏感性躯体形式障碍的疗效。方法:将66例治疗不敏感性躯体形式障碍患者随机分成文拉法辛中剂量组及文拉法辛高剂量组,于治疗前、治疗后12、、4、6周末采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、SCL-90的躯体化因子评定疗效,用不良反应量表(TESS)在治疗后12、、4、6周末评定不良反应。结果:中高剂量两组间疗效无显著差异(x2=0.90,P>0.05)。入组时两组间SCL90躯体化因子、HAMD、HAMA评分差异无显著意义,高剂量组在2、46、周末有下降,而中剂量组在46、周末才下降2,周末3个指标的评分两组间存在差异4,周末与6周末两组的评分无差异,提示高剂量组起效快于中剂量组,但两组6周末的疗效大致相当。TESS评分两组无明显差异。结论:中高剂量文拉法辛对治疗不敏感性躯体形式障碍的疗效及不良反应相当,但高剂量组起效快。

Objective：To explore the efficacy of middle dose and high dose of venlafaxine in the treatment of treatment non - response somatoform disorders. Methods ：66 patients with the diagnosis of treatment non -response somatoform disorders were randomly divided into middle dose of venlafaxine group and high dose of venlafaxine group. The efficacy was evaluated by HAMD, HAMA and the Somatlzatlon factor of SCL -90 at pre -treatment and 1,2, 4, 6 weekend after treatment. The side effects were assessed by TESS at 1, 2, 4, 6 weekend after treatment. Results： There was no significant difference in the efficacy between middle dose of venlafaxine group and high dose of venlafaxine group （ x^2 = 0. 90, P 〉 0.05 ）. There were no significant differences in HAMD, HAMA and the Somatization factor of SCL - 90 at pre - treatment and 1,4, 6 weekend after treatment between the two groups. However the difference in HAMD, HAMA and the Somatization factor of SCL - 90 was significant at 2 weekend after treatment between the two groups, There was no difference in TESS between the two groups. Conclusions ： Middle dose and high dose of venlafaxine had similar efficacy and TESS in treatment of treatment non - response somatoform disorders. But high dose of venlafaxine group had instant effect.