度洛西汀与氟西汀改善躯体形式障碍患者症状及社会功能效果的对照研究

A comparative study of duloxetine vs. fluoxetine for improving symptoms and social function of patients with somatoform disorder

目的探讨度洛西汀与氟西汀对改善躯体形式障碍患者症状及社会功能的效果。方法将134例躯体形式障碍患者随机分为研究组(度洛西汀系统治疗)和对照组(氟西汀系统治疗),共治疗8周。在基线及治疗后第1、2、4、8周末采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会功能缺陷量表(SDSS)及治疗中需处理的不良反应症状量表(TESS)评定疗效及不良反应。结果研究组患者在治疗后第1周末起HAMD及HAMA量表评分均显著低于基线时(P<0.05),而对照组治疗后第2周末起HAMD及HAMA量表评分均显著低于基线时(P<0.05);治疗后第1、2、4、8周末研究组HAMD及HAMA量表评分均低于对照组(P<0.05)。研究组治疗后第4周末起SDSS量表评分显著低于基线时(P<0.05),而对照组治疗后第8周末SDSS量表评分显著低于基线时(P<0.05)。治疗后第4、8周末研究组SDSS量表评分均低于对照组(P<0.05)。两组均未出现严重不良反应。结论度洛西汀可有效、快速的改善躯体形式障碍患者的抑郁、焦虑症状及社会功能,效果优于氟西汀。

Objective To explore the efficacy of duloxetine vs.fluoxetine for improving symptoms and social function of patients with somatoform disorder.Methods 134 patients with somatoform disorder were randomly divided into study group treated with duloxetine and control group treated with fluoxetine for 8 weeks.They were assessed with Hamilton Depression Scale （HAMD）,Hamilton Anxiety Scale （HAMA）,Social Disability Screening Schedule （SDSS） and Treatment Emergent Side Effect Scale （TESS） at baseline and at the end of the 1st,2nd,4th and 8th week to evaluate the efficacy and side effects.Results Compared with baseline,scores of HAMD and HAMA in study group decreased significantly at the end of the 1 st week （P ＜0.05）,while in control group the significance appeared till at the end of the 2nd week （P ＜ 0.05）.Scores of HAMD and HAMA in study group at the end of 1st,2nd,4th,8th week were significantly lower than those in control group （P ＜0.05）.Score of SDSS at the end of the 4th week in study group was significantly lower than that at baseline （P ＜ 0.05）,while the significance appeared till at the end of the 8th week in control group （P ＜ 0.05）.Scores of SDSS at the end of the 4th and 8th week in study group were significantly lower than those in control group （P ＜ 0.05）.There was no severe side effects in both groups.Conclusion Duloxetine is effective in improving anxiety,depressive symptoms and social function of patients with somatoform disorder.Moreover,it takes effect rapidly.The efficacy of duloxetine is better than that of fluoxetine.