文拉法辛联合喹硫平与单用文拉法辛治疗躯体形式障碍的对照研究

Comparison study of venlafaxine combined with quetiapine versus single venlafaxme in treatment of somatoform disorders

目的研究文拉法辛联合喹硫平治疗躯体形式障碍(SD)的疗效及安全性。方法 167例躯体形式障碍患者随机分为2组,研究组(84例)予以文拉法辛(145±25)mg·d^(-1)合并喹硫平(255±12)mg·d^(-1)治疗,对照组(83例)单用文拉法辛(155±37)mg·d^(-1)治疗;疗程均为8 wk。治疗前与治疗后wk 2、wk 8末采用症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)评定临床疗效,不良反应症状量表(TESS)评价安全性。结果研究组脱落2例,完成82例;对照组脱落1例,完成82例。2组治疗wk 2末的SCL-90躯体化、HAMD评分均较治疗前显著减少(P<0.05,P<0.01);wk 8末研究组SCL-90躯体化、HAMD评分和对照组相比均有非常显著差异(P<0.01)。研究组治疗有效率83%,对照组59%,组间有非常显著差异(P<0.01)。2组TESS评分无显著差异(P>0.05),不良反应均表现较轻,大多出现在治疗的早期,并逐渐缓解。结论文拉法辛联合喹硫平治疗躯体形式障碍较单用文拉法辛疗效好,不良反应相当。

AIM To study the clinical treatment of sornatoform disorders. （venlafaxine （ 145± 25） mg. d-1 （venlafaxine （155 ± 37） mg＇d-1, METHOD combined n= 83） effects and safety of venlafaxine combined with quetiapine in into study group and control group the ends of wk 2,wkSof treatment, the clinical effects and safety were assessed with SCL-90, HAMD, and TESS. RESULTS The study group completed 82 patients with 2 patients dropped, and the control group completed 82 patients with 1 patient dropped. At the end of wk 2 of the treatment, the scores of SCL-90 somatization and HAMD of the two groups were lower than those before the treatment （P 〈 0.05, P 〈 0.01）. At the end of wk 8, there were significant differences in the scores of SCL-90 somatization and HAMD between the two groups （P 〈 0.01）. The effective rates of the study group and control group were 83% and 59% respectively, with a significant difference （P 〈 0.05） . There was no significant difference between the TESS socres of the two groups （P 〉 0.05）. Adverse reactions of the two groups were milder, and most of those occurred in the initial stage of the treatment and gradually remitted via expectant treatment. CONCLUSION The efficacy of venlafaxine combined with quetiapine is better than that of single venlafaxine in the treatment of somatoform disorders, and the safety is equivalent.