文拉法辛联合小剂量多塞平治疗躯体形式障碍的疗效观察

Efficacy of venlafaxine combined with a small amount of doxepin treatment of somatoform disorders

目的探讨文拉法辛联合小剂量多塞平治疗躯体形式障碍的疗效及安全性。方法将64例躯体形式障碍患者随机分为研究组(文拉法辛联合多塞平组)与对照组(文拉法辛组)各32例,分别予文拉法辛联合小剂量多塞平与文拉法辛治疗,疗程均为8周。临床疗效评定分别采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表-病情严重度(CGI-SI)及治疗时出现的症状量表(TESS)于治疗前后进行评定。结果研究组在治疗第2,4,6,8周末HAMA总分显著低于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2周末精神性焦虑分低于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2,4周末HAMA减分率均高于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2,8周末HAMD总分显著低于对照组,差异有统计学意义(P<0.05或P<0.01)。研究组在治疗第2,8周末HAMD减分率均高于对照组,差异均有统计学意义(P均<0.01)。研究组总有效率为93.75%与对照组总有效率为87.50%比较,差异无统计学意义(P>0.05),研究组的显效率为75.00%与对照组的50.00%比较,差异有统计学意义(P<0.05)。两组的不良反应均少,在治疗第8周末两组的TESS评分比较差异无统计学意义(P>0.05)。结论文拉法辛联合小剂量多塞平治疗躯体形式障碍疗效优于单用文拉法辛,且无明显不良反应。

Objective To explore the efficacy and safety of venlafaxine combined with a small amount of doxepin treatment of somatoform disorders. Methods 64 patients with somatoform disorders were randomly divided into study group （venlafaxine combined with doxepin group）and the control group （venlafaxine group）32 eases eacht, respectively, taking venlafaxine combined with a small amount of doxepin and venlafaxine treatment lasted 8 weeks. Clinical effieaeies were assessed with the Hamilton de- pression scale（ HAMD- 17）and the Hamilton anxiety scale（HAMA） and the clinical global impression severity of illness（ CGI- SI ） and adverse reactions with the treatment emergent symptom scale（TESS） before treatment and after treatment. Results The re- search group in the treatment of 2,4,6,8 weekend HAMA total score decreased significantly faster than the control group, the difference was statistically significant（ P 〈0. 05 ）. The study group in the treatment of the second weekend of spiritual anxiety fall faster than the control group, the difference was statistically significant（ P 〈 0.05 ）. The study group and after treatment 2,4 week- end HAMA minus points rate difference higher than that of the control group was statistically significant （ P 〈 0. 05 ）. The study group after treatment 2,8 weekend HAMD total score decreased significantly faster than the control group the difference was statis- tically significant（ P 〈 0. 05 or P 〈 0. 01 ）. The study group after treatment 2,8 weekend HAMD the less points rate higher than that of the control group differences were statistically significant（ P 〈 0. 01 ）. The study group~ total efficiency of 93.75% compared with 87.50% of the total effective rate of the control group the difference was not statistically significant（ P 〉 0. 05 ）. The study was the efficiency of 75.00% compared with 50.00% of the control group, the difference was statistically significant （ P 〈 0. 05 ）. Adverse reactions in the two groups are rare, TESS scores between the two groups of 8 weeks after treatment showed no significant difference （ P 〉 0. 05 ）. Conclusion Venlafaxine combined with a small amount of doxepin treatment of somato- form disorders better than the efficacy of venlafaxine alone and mild adverse reactions.