艾司西酞普兰与帕罗西汀治疗抑郁症伴焦虑症状对照研究

A control study of escitalopram vs. paroxetine in the treatment of depression with anxious symptoms

目的探讨艾司西酞普兰与帕罗西汀治疗抑郁症伴焦虑症状的临床疗效和安全性。方法将118例抑郁症伴焦虑症状患者随机分为两组，研究组58例，口服艾司西酞普兰治疗，对照组60例，口服帕罗西汀治疗，观察8周。于治疗前及治疗1周、2周、4周、6周、8周末采用汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组汉密顿抑郁量表及汉密顿焦虑量表评分均较治疗前显著下降（P〈0.05或0．01），研究组治疗1周末较对照组下降更显著（P〈0．05或0．01）；治疗8周末，研究组显效率75．9％、总有效率91．4％，对照组分别为71．7％、90．0％，两组比较差异无显著性（P〉0．05）。两组不良反应发生率比较差异无显著性（P〉0.05），但研究组性功能障碍发生率显著低于对照组（χ^2=4．66，P〈0.05）。结论艾司西酞普兰与帕罗西汀治疗抑郁症伴焦虑症状疗效显著，总体疗效相当，安全性高，依从性好，但艾司西酞普兰起效更快，可作为治疗抑郁症伴焦虑症状的首选药物。

Objective to explore the efficacy and safety of escitalopram and paroxetine in the treatment of depression with anxious symptoms. Methods A total of 118 depression patients with anxious symptoms were randomly divided into research group （n=58） taking orally escitalopram and control group （n：60） doing paroxetine for 8 weeks. Efficacies were assessed with the Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） at baseline and at the end of the 1^st, 2^nd, 4^th, 6^th and 8th week and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results After treatment the HAMD and HAMA scores of both groups lowered more significantly compared with pretreatment （P〈 0.05 or 0.01）, so did those in research than in control group at the end of the 1^st week （P〈0.05 or 0. 01） ; at the end of the 8^th week. Obvious and total effective rate were respectively 75.9% and 91.4% in research and 71.7% and 90.0% in control group, which showed no significant differences （P〉0. 05）. There were no significant group differences in incidences of adverse reactions （P〉0.05）, but the incidence of sexual dysfunction was significantly lower in research than in control group （χ^2= 4.66, P〈0.05）. Conclusion Both escitalopram and paroxetine have evident effect, high safety and good compliance and their total efficacy are equivalent in the treatment of depression with anxious symptoms, but the former takes effect more rapidly and could be used as the choice drug for depression with anxious symptoms.