度洛西汀与帕罗西汀治疗抑郁症合并躯体症状临床观察

Clinical observation of duloxetine and paroxetine in depression complicated with somatic symptoms

目的比较度洛西汀与帕罗西汀治疗抑郁症合并躯体症状的临床疗效。方法将42例抑郁症合并躯体症状患者随机分为两组，分别予以度洛西汀、帕罗西汀治疗。于治疗前后采用汉密顿抑郁量表、副反应量表评定疗效及不良反应。结果度洛西汀组显效率高于帕罗西汀组，但差异无显著性（P〉0．05）。治疗后两组汉密顿抑郁量表总分均较治疗前显著降低（P〈0．01），治疗2周末度洛西汀组较帕罗西汀组下降更显著（P〈0．01）；治疗4周、6周末两组躯体化焦虑因子分较治疗2周末显著降低（P〈0．01），且度洛西汀组较帕罗西汀组下降更显著（P〈0．05或0．01）。两组不良反应无明显差异性。结论度洛西汀与帕罗西汀治疗抑郁症合并躯体症状疗效显著且相当，度洛西汀改善躯体症状的效果更佳。

Objective To compare the efficacy between duloxetine and paroxetine in depression complicated with somatic symptoms. Methods Forty-two depression patients complicated with somatic symptoms were randomly assigned to two groups treated with duloxetine or paroxetine. Efficacies were assessed with the Hamilton Depression Scale （HAMD） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before and after treatment. Results Obvious effective rate was higher in duloxetine than in paroxetine group, but difference weren＇t significant （P〉0.05）. The total scores of the HAMD of both groups lowered more significantly compared with pretreatment （P〈0.01）, so did that in duloxetine than in paroxetine group at the end of the 2^nd week （P〈0.05 or 0.01）; somatization anxiety scores of both groups lower ed significantly at the end of the 4^th and 6^th week than at the end of the 2^nd （P〈（0.01）, so did those in duloxetine than in paroxetine group at the end of 4^th and 6^th week. There were no significant group differences in adverse reactions. Conclusion Duloxetine and paroxetine have an equivalent evident effect in depression complicated with somatic symptoms, the former has an advantage in improving somatic symptoms over the latter.