度洛西汀联合帕利哌酮治疗躯体化障碍的研究

Duloxetine combined with paliperidone in the treatment of somatization disorder

目的探讨度洛西汀合并小剂量帕利哌酮治疗躯体化障碍的疗效及安全性。方法将63例躯体化障碍患者随机分为研究组(32例)和对照组(31例),分别给予度洛西汀联合帕利哌酮和度洛西汀,疗程均为8周。于治疗前及治疗后第2、4、6、8周末应用躯体形式症状筛查量表(screening for somatoform symptoms-7,SOMS-7)、汉密尔顿抑郁量表17项(hamilton depression rating scale,17 items:HAMD-17)、汉密尔顿焦虑量表(hamilton anxietyscale,HAMA)及不良反应症状量表(treatment emergent symptom scale,TESS)评定疗效及不良反应。结果治疗后两组SOMS-7、HAMD和HAMA评分均较治疗前显著减少(P<0.01)。8周末研究组及对照组的有效率分别为87.5%和64.6%,两组的显效率分别为62.5%和29.1%,两组差异均有统计学意义(P<0.05或P<0.01)。治疗第2周末研究组HAMD评分显著低于对照组(P<0.01)。两组不良反应的发生率差异不显著(P>0.05)。结论度洛西汀合并帕利哌酮治疗躯体化障碍较单用度洛西汀具有疗效好、起效快的优点,且不增加不良反应。

Objective To explore the clinical efficacy and safety of duloxetine in combination with small-dosage paliperidone in the treatment of somatization disorder.Methods A total of 63 patients with somatization disorder were randomly divided into a study group（32 cases） and a control group（31 cases）,treated with duloxetine in combination with paliperidone and duloxetine alone,respectively,for 8 weeks.The clinical efficacy and side effects were evaluated at the end of 2,4,6 and 8 weeks,and compared with before-treatment,using Screening for Somatoform Symptoms-7（SOMS-7）,Hamilton Depression Rating Scale（HAMD-17）,Hamilton Anxiety Scale（HAMA） and Treatment Emergent Symptom Scale（TESS）.Results For both the study group and control group,scores on SOMS-7,HAMD and HAMA were significantly lower after treatment than before treatment（P0.01）.At the end of the 8th week,the effective rates of the study group and the control group were 87.5% and 64.6%,respectively,and the effectual rates of the two group were 62.5% and 29.1%,respectively,for both categories,with the differences being significant（P0.05 or P0.01）.At the end of the second week,the HAMD score for the study group was significantly lower than for the control group（P0.01）.There were no significant differences between the two groups in ADR rates（P0.05）.Conclusions For the treatment of somatization disorder,duloxetine in combination with small-dosage paliperidone worked better and faster than duloxetine alone,without added side effects.