合并小剂量喹硫平治疗躯体形式疼痛障碍的临床研究

Clinical study of citalopram combined with low dose quetiapine in treatment of somatoform pain disorders

目的:探讨合并小剂量喹硫平对躯体形式疼痛障碍的疗效及安全性。方法:对81例躯体形式疼痛障碍的患者随机分成研究组(41例)和对照组(40例),研究组给予西酞普兰合并小剂量喹硫平系统治疗,对照组给予西酞普兰系统治疗,疗程均为6周。入组患者分别于治疗前、治疗后1,2,4,6周末采用汉密尔顿抑郁量表(HAMD)、疼痛量表(MOSPM)评定疗效,用治疗时出现的症状量表(TESS)在治疗后1,2,4,6周末评定不良反应。结果:与治疗前相比,研究组HAMD及MOSPM评分在第1周末即有显著性降低(P<0.05)。而对照组HAMD及MOSPM评分在第2周末才有显著性降低(P<0.05)。在治疗后的第6周末,研究组整体疗效优于对照组(P<0.05)。两组抗疼痛临床治疗TESS评分无显著差异。结论:合并小剂量喹硫平治疗躯体形式疼痛障碍与西酞普兰系统治疗相比,疗效肯定,起效快,安全性高,依从性好。

Objective：To explore efficacy and safety of citalopram combined with low dose quetiapine in treatment of somato- form pain disorders. Methods：Eighty-one patients with the somatoform pain disorders were randomly divided into study group （41 ca- ses） and control group （40 cases）, wherein the cases were treated with citalopram combined with low dose quetiapine and citalopram for 6 weeks, respectively. The efficacy was evaluated by Hamilton depressive scale （HAMD） and medical outcomes study pain meas- urement （MOSPM） before and week 1, 2, 4 and 6 weeks after the treatment. The side effects were assessed by treatment emergent symptom scale （TESS） 1, 2, 4 and 6 weeks after the treatment. Results： After the treatment, the scores of HAMD and MOSPM of study group decreased significantly 1 week after the treatment （ P〈0.05 ）, whereas those of control group decreased 2 weeks after the treatment （ P〈0.05 ）. 6 weeks after the treatment, the whole curative effects of study group were better than those of control group （ P 〈0.05 ）. There was no significant difference in TESS scores between the two groups. Conclusions ： Compared with citalopram, citalo- pram combined with quetiapine in the treatment of somatoform pain disorders is more effective and has high safety and good compli-