盐酸舍曲林对心脏内科躯体化障碍的临床疗效观察

Clinical effect of sertraline hydrochloride on somatization disorder in department of cardiology

目的:评价盐酸舍曲林治疗心内科躯体化障碍患者的临床疗效和副作用。方法:将符合CCMD-3诊断标准的78例躯体化障碍患者随机分为治疗组和对照组各39例。两组病例均给予相同心理干预治疗,治疗组加用舍曲林口服,起始剂量25 mg·d-1,如无不良反应3 d后增至50 mg·d-1,对于每日50 mg疗效不佳且药物耐受性较好的患者可增加剂量,最大剂量可升至200 mg·d-1,疗程12周。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评定疗效及不良反应。结果:经12周治疗后,治疗组临床有效率(89.7%)较对照组(48.7%)高(P<0.05)。治疗组治疗4周和12周后SAS、SDS评分均较首次评定显著下降(P<0.01),且治疗组12周时SAS、SDS评分均较4周时下降(P<0.05)。结论:盐酸舍曲林对心内科躯体化障碍疗效佳,使用安全,无明显副作用。

Objective： To evaluate the clinical efficacy and side effects of sertraline hydrochloride in treatment of patients with somatization disorder in department of cardiology. Methods： A total of 78 patients with somazation disorder according to the CCMD-3 diagnosis standard were randomly divided into treatment group and control group with 39 cases in each group. Two groups were given the same psychological intervention therapy,while treatment group was added sertraline with an initial dose of 25 mg · d^- 1. If there was no adverse reaction,the dose was increased to 50 mg·d^- 13 days later. For patients whose reaction was not good,the dose could be increased and the maximum dose was 200 mg·d^- 1. The efficacy was evaluated by the Self rating Anxiety Scale（ SAS） and Self rating Depression Scale（ SDS）. Results： After 12 weeks of therapy,the efficiency of clinical symptoms in sertraline treatment group was 89. 7%,higher than that in control group（ 48. 7%,P 〈0. 05）. The SAS and SDS scores were significantly decreased after 4 weeks and 12 weeks in sertraline treatment group（ P 〈0. 01）. Furthermore,the scores of 12 weeks were lower than those of 4 weeks（ P 〈0. 05）. Conclusion： Sertraline is effective and safe for somatization disorder in department of cardiology.