瑞波西汀与度洛西汀治疗持续性躯体形式疼痛障碍的对照研究

Comparative study of reboxetine and duloxetine on persistent somatoform pain disorder

目的 探讨瑞波西汀和度洛西汀治疗持续性躯体形式疼痛障碍（PSPD）的疗效和安全性.方法 将93例PSPD患者按随机数字表法分为瑞波西汀组（47例）和度洛西汀组（46例）,并予相应药物治疗8周.分别于治疗前和治疗后2,4,8周应用视觉模拟评分法（VAS）、汉密尔顿抑郁量表-17（HAMD-17）、汉密尔顿焦虑量表（HAMA）进行评定.应用治疗过程中出现的不良反应量表（TESS）评定药物不良反应.结果 治疗后两组患者的VAS、HAMD-17、HAMA评分均有不同程度的降低,治疗2周末时,瑞波西汀组各项评分均低于度洛西汀组,治疗4周末时,瑞波西汀组VAS和HAMD评分低于度洛西汀组,且差异有统计学意义（P＜0.05）,治疗8周末时,两组间各项评分比较差异均无统计学意义（P＞0.05）.治疗8周末两组间疗效差异无统计学意义.8周末除了度洛西汀组嗜睡、性功能障碍明显增多外,两组整体药物不良反应差异无统计学意义.结论 瑞波西汀和度洛西汀组都能明显改善PSPD患者疼痛及情绪症状,安全性好.对于疼痛症状突出者可优先考虑瑞波西汀.

Objective To explore the efficacy and safety of reboxetine and duloxetine on persistent somatoform pain disorder （PSPD）. Methods Totals of 93 PSPD patients were divided into reboxetine group （47 cases） and duloxetine group （46 cases） randomly, and treated with corresponding antidepressant for 8 weeks. The patients were assessed with Visual Ana-logue Scale （VAS）, Hamilton Anxiety Scale （HAMA）, Hamilton Depression Scale （HAMD） before treatment, and at 2,4,8 weeks after teaetment respectively. The side effect was assessed with Treatment Emergent Symptom Scale （TESS） at 2, 4,8 weeks after treatment. Results Compared before treatment, the scores on VAS, HAMD-17 and HAMA decreased in two groups. All scores in reboxetine group were significantly decreased than duloxetine group at 2 weeks after treatments the scores of VAS and HAMD were significantly decreased than duloxetine group at 4 weeks after treatment （P 〈 0.05）. There was no significant difference in all scores between the two groups at 8 weeks （P 〉 0.05） except for lethargy and sexual dysfunction increased sig- nificantly in duloxetine group. Conclusions Reboxetine and duloxetine are safe and effective on PSPD patients＇ pain and emotional symptoms. Reboxetine may be taken into account preferentially on the patients with pain symptoms.