度洛西汀联合奥氮平治疗躯体形式障碍患者的临床分析

Clinical analysis of treating somatoform disorders by duloxetine combined with olanzapine

目的:探讨度洛西汀联合小剂量奥氮平治疗躯体形式障碍患者的疗效和安全性。方法:120例躯体形式障碍患者随机分为研究组即度洛西汀联合小剂量奥氮平组和对照组即单用度洛西汀组,各60例疗程6周。治疗前后以汉密尔顿焦虑量表(HAMA)、密尔顿抑郁量表(HAMD)的疑病条目、阿森斯失眠量表(AIS),临床疗效总评量表(CGI)进行疗效评估,以治疗时出现的症状量表(TESS)评估用药的安全性。结果:治疗第2周,研究组HAMA和CGI-GI评分显著低于对照组(P均<0.01)。治疗第6周,两组显效率基本接近,对照组的疑病观念的残留率高于研究组(P<0.05)。两组第2、4、6周的HAMA评分均显著低于治疗前(P<0.01)。第1周及第6周,对照组的治疗脱落率显著高于研究组(P均<0.05)。治疗第1周末,对照组的恶心呕吐以及失眠的发生率显著高于研究组(P<0.05)。结论:度洛西汀联合小剂量奥氮平治疗躯体形式障碍较单用度洛西汀,具有疗效好、起效快、恶心呕吐不良反应少,脱落率低的优点。

Objective：To explore the efficacy and safety of duloxetine combined with low dose olanzapine in the treatment of somatoform disorders. Method：A total of 120 patients with somatoform disorders were randomly divided into study group with duloxetine combined with small dosage of olanzapine and control group with duloxetine for the treatment of somatoform disorders for 6 weeks. They were assessed using Hamilton anxiety scale（HAMA）,Hamilton depression scale（HAMD）,Athens insomnia scale（AIS）,clinical global impression （CGI）to evaluate the efficacy and treatment emergent side effect scale（ TESS）to evaluate the safety. Results：In the 2nd weekend,the scores of HAMA and CGI-GI in study group were significantly lower than those in control group（all P 〈 0. 01）. In the 1st and 6th weekend,the dropout rate of control group was significantly larger than that of study group（all P 〈 0. 05）. In the 1st weekend,the incidence rate of nausea and vomiting in control group was significantly larger than that in study group. Conclusion：Duloxetine combined with small dosage of olanzapine in the treatment of somatoform disorder takes effects faster than single duloxetine and has lower dropout rate.