文拉法辛与帕罗西汀治疗广泛性焦虑的对照研究

Control study of venlafaxine versus paroxetine in the treatment of generalized anxiety disorder

目的比较文拉法辛与帕罗西汀治疗广泛性焦虑的疗效、功能改善及安全性。方法将68例广泛性焦虑患者随机分为2组,观察组服用文拉法辛,对照组服用帕罗西汀片,疗程6周。于治疗前及治疗后第1、2、4、6周末进行汉密尔顿焦虑量表(HAMA)、功能大体评定量表(GAF)及副反应量表(TESS)评定。结果两组患者HAMA总分、精神焦虑评分、躯体焦虑评分均呈下降趋势,观察组治疗第1周后的总分、精神焦虑因子分及治疗第2周后的躯体焦虑因子分各时点与治疗前比较差异均有统计学意义(P<0.05),对照组治疗第2周后的总分、精神焦虑因子分及治疗第4周后的躯体焦虑因子分各时点与治疗前比较差异均有统计学意义(P<0.05),但两组间主效应比较差异无统计学意义(P>0.05),观察组下降幅度较对照组下降幅度大,差异具有统计学意义(P<0.05)。两组患者GAF评分均呈不断升高趋势,治疗1周后各时点与治疗前比较差异均有统计学意义(P<0.05),但两组间主效应比较差异无统计学意义(P>0.05),两组间上升幅度比较差异无统计学意义(P>0.05);两组合并使用苯二氮卓类药物率差异无统计学意义(P>0.05);两组不良反应差异无统计学意义(P>0.05)。结论文拉法辛与帕罗西汀治疗广泛性焦虑安全、有效,能够较好改善社会功能,文拉法辛起效较快,改善躯体症状较好。

Objective To compare the effect , social function and safety of venlafaxine versus paroxetine in the treatment of general anxiety disorder .Methods Sixtyeight patients with generalized anxiety disorder were ran-domly divided into two groups .The observation group was given venlafaxine , the control group was given paroxetine for 6 weeks.The Hamilton Anxiety Scale（HAMA）,global assessment function（GAF） and side effects scale（TESS） were used to assess the therapeutic effects before treatment and at the end of the 1st,2nd,4th,6th week after treatment, respectively.Results There was declined trend in HAMA′s total scores, mental anxiety scores and somatic anxiety scores in two groups .The MAMA′s total scores, mental anxiety scores at every time points after 1st week′s treatment and the HAMA′s somatic anxiety somatic anxiety scores at every time points after 2nd week′s treatment were significantly decreased in the observation group compared with those before treatment （ P〈0.05 ） .The HAMA′s total scores, mental anxiety scores at every time points after 2nd week′s treatment, the HAMA′s somatic anxiety scores at every time points after 4th week′s treatment were significantly decreased in the control group compared with those be-fore treatment （ P〈0.05 ） .There was no statistically difference in the main effect of HAMA′s scores between two groups（P 〉0.05）.The declined amplitude in HAMA scores in the observation group was significantly greater than that in the control group （ P〈0.05 ） .There was an ascended trend in GAF′s scores in two groups .The GAF′s scores at every time points after 1st week′s treatment were significantly increased compared with those before treatment （P〉0.05 ） ,but there were no statistically difference in the main effect of GAF′s scores and the ascended amplitude in GAF′s scores between two groups （ P〉0.05 ） .There were no statistically difference in the rate of adverse reaction and the use of diazepams （ P〉0.05 ） .Conclusion Using venlafaxine and paroxetine for treating generalized anxiety disorder are effective and safe , but venlafaxine acts more rapidly and more improves the somatic symptoms compared with paroxetine .