帕罗西汀治疗干燥综合征相关焦虑抑郁障碍的疗效观察

The curative effect of paroxetine in treatment of anxiety and depression disorder in Sj gren's syndrome patients

目的：探讨盐酸帕罗西汀对干燥综合征患者焦虑、抑郁障碍的治疗效果。方法将120例干燥综合征伴焦虑、抑郁患者采用随机数字表分为对照组和治疗组各60例，两组均给予干燥综合征常规治疗和心理治疗，治疗组在此基础上辅以帕罗西汀口服，起始剂量10 mg，根据患者情况加量至20～40 mg qn，疗程12周。分别在治疗前及治疗4、8和12周对患者进行汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）评定和干燥综合征疾病活动度评分（ESSDAI）及患者自觉症状评分（ESSPRI）。结果治疗4、8和12时，治疗组HAMA、HAMD评分较治疗前有明显下降（P＜0.05），且与对照组比较差异有统计学意义（ P＜0.05）。治疗组焦虑、抑郁障碍痊愈率为16.7％、显效率36.7％，总有效率86.7％；对照组分别为5.0％、16.7％、51.7％，两组总有效率比较差异有统计学意义（χ2＝17.232，P＜0.01）。在治疗第8周及12周时，治疗组ESSPRI评分明显低于对照组，差异有统计学意义（ P＜0.05）。结论在治疗原发病及心理干预治疗的基础上加用帕罗西汀，能明显改善干燥综合征患者焦虑、抑郁障碍，且能显著改善患者主观症状。

Objective To study the effect of paroxetine in treatment of anxiety and depression disorder in Sj gren ＇s syndrome patients .Methods One hundred and twenty Sj gren＇s syndrome patients who suffered from anxiety and depression disorder were divid-ed randomly into two groups , 60 in each group .All the patients received conventional therapy according patient＇s condition and psycho-therapy by professional psychotherapist .Treatment group received paroxetine at the same time with initial dose of 10 mg qn, which can be added to 20~40 mg according to patients＇situations.Course of treatment was 12 weeks.Hamilton anxiety scale （HAMA）, Hamilton depression scale （HAMD）, EULAR Sj gren＇s syndrome disease activity index （ESSDAI）, EULAR Sj gren＇s syndrome patients repor-ted index （ESSPRI） were applied before and after 4, 8 and 12 weeks after treatment.Results HAMA and HAMD were declined in the treatment group after 4 weeks of treatment , that were significantly different from the control group （ P〈0.05 ） .The cure rate , obvi-ous effective rate and total effective rate in the treatment group were 16.7%, 36.7%and 86.7%, respectively.They were significantly different from the control group in which the cure rate , obvious effective rate and total effective rate were 5.0%, 16.7%and 51.7%, respectively （χ2=17.232 ,P〈0.01 ） .ESSPRI in the treatment group was significantly lower than that in the control group after 8 and 12 weeks of treatment （ P〈0.05 ） .Conclusion Paroxetine can obviously ameliorate the anxiety and depression disorder in Sj gren＇s syndrome patients , and improve the ESSPRI .