度洛西汀与氟西汀治疗抑郁症伴疼痛患者对照研究

A control study of duloxetine vs fluoxetine in the treatment of depression patient with pain

目的：探讨度洛西汀与氟西汀治疗抑郁症伴疼痛症状患者的疗效和安全性。方法将100例抑郁症伴疼痛症状患者随机分为两组，观察组口服度洛西汀治疗，对照组口服氟西汀治疗，观察8周。于治疗前后采用汉密顿抑郁量表、医学结局研究用疼痛量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组各量表评分均较治疗前显著下降（P＜0．01），治疗4周末起观察组医学结局研究用疼痛量表评分显著低于对照组（ P＜0．05或0．01），治疗8周末观察组痊愈率为52．4％、总有效率为85．7％，对照组分别为48．9％、80．0％，两组比较差异无显著性（χ^2＝0．11、0．50，P＞0．05）。两组不良反应较轻微，主要表现为失眠和胃肠道反应。结论度洛西汀与氟西汀均能改善抑郁症伴疼痛症状患者的抑郁、疼痛等症状，总体疗效相当，安全性高，但度洛西汀改善疼痛症状效果更显著。

Objective To compare the efficacy and safety of duloxetine vs fluoxetine in the treatment of de‐pression patient with pain .Methods One hundred depression patients with pain were randomly assigned to two groups ,observation group took orally duloxetine and control group did fluoxetine for 8 weeks .Effi‐cacies were assessed with the Hamilton Depression Scale （HAMD） and Medical Outcomes Study Pain Measurement （MOSPM ） before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale （TESS） .Results After treatment each scale scores of both groups lowered more signifi‐cantly compared with pretreatment （P〈0 .01） ,since the end of the 4th week the MOSPN score was signifi‐cantly lower in observation than control group （P〈0 .05 or 0 .01）;at the end of the 8th week cure and total effective rate were respectively 52 .4% and 85 .7% in observation and 48 .9% and 80 .0% in control group , which showed no significant group differences （χ^2 = 0 .11 ,0 .50 ;P〉 0 .05） .Adverse reactions of both groups were mild and mainly insomnia and gastrointestinal reactions .Conclusion Both duloxetine and flu‐oxetine could improve depressive and painful symptoms of depression patients with pain ,their total effica‐cies are equivalent ,both have higher safety ,but duloxetine has an advantage in improving painful symp‐toms over fluoxetine .