度洛西汀联合奥氮平治疗躯体化障碍临床对照研究

Clinical control study of Duloxeline combined with Olanzapine in treatment of somatization disorder

目的:探讨度洛西汀联合奥氮平治疗躯体化障碍临床疗效及安全性。方法:将100例躯体化障碍患者随机分为研究组与对照组,研究组患者以度洛西汀联合奥氮平治疗,对照组患者单用度洛西汀治疗,疗程8周。于患者治疗前及治疗后2、4、6、8周采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)分别评定患者的临床疗效和不良反应。结果:治疗后两组患者HAMD-17和HAMA评分均较治疗前显著减少(P<0.01);研究组患者有效率为81.63%,对照组患者有效率为61.70%,两组患者有效率经x2检验差异有统计学意义(P<0.05);治疗2周末研究组患者HAMD-17及HAMA评分均较对照组下降显著(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05),但研究组患者在失眠、食欲减退、焦虑不安方面发生率明显低于对照组(P均<0.05)。结论:度洛西汀联合奥氮平治疗躯体化障碍起效快、疗效优于单用度洛西汀;且能改善失眠、焦虑及食欲减退等躯体化症状。

Objective：To explore the clinical efficacy and safety of Duloxeline combined with Olanzapine in treatment of soma-tization disorder. Methods：A total of 100 patients with somatization disorder were randomly divided into study group and control group. The patients in study group were treated with duloxeline combined with olanzapine for 8 weeks, whereas those in control group were treated with duloxeline alone for 8 weeks. The clinical efficacy and side effects were assessed before and 2, 4, 6, and 8 weeks after the treatment by using Hamilton depression rating scale （HAMD-17）, Hamilton anxiety scale （HAMA） and treatment emergent symptom scale （TESS）. Results： For both study group and control group, the scores of HAMD-17 and HAMA after the treatment were signifi-cantly lower than those before the treatment （P〈0. 01）. The effective rate of study group was 81. 63% , while that of control group was 61. 7% , and the difference between the two groups tested by x2 was statistically significant （P〈0. 05）. 2 weeks after the treatment, the HAMD-17 score and HAMA score for study group decreased significantly than those for control group （P〈0. 05）. There was no statistical difference between the two groups in incidence rate of the adverse reactions （P〉0. 05）; however, the incidence rates of in-somnia, anorexia, and anxiety of study group were significantly lower than those of control group （all P〈0. 05）. Conclusions： For the treatment of somatization disorder, duloxeline combined with olanzapine works better and faster than duloxeline alone. It can improve the somatization symptoms like insomnia, anxiety, appetite and the like.