度洛西汀联合帕利哌酮治疗躯体形式障碍患者的疗效及安全性分析

Efficacy and safety of duloxetine combined with paliperidone in the treatment of somatoform disorders

目的探讨度洛西汀联合帕利哌酮治疗躯体形式障碍患者的疗效及安全性。方法选取2019年7月至2021年10月攀枝花市第三人民医院接受治疗的躯体形式障碍患者,采用随机数字表法将其分为奥氮平组和帕利哌酮组。两组患者均由专业的咨询师进行森田疗法相关的心理治疗,奥氮平组在心理治疗的基础上给予度洛西汀联合奥氮平治疗,帕利哌酮组给予度洛西汀联合帕利哌酮治疗。比较两组患者的疗效,治疗前及治疗后2周、4周和8周测试的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和90项症状自评量表(SCL-90)评分,并比较两组患者的不良反应发生情况。结果共纳入106例患者,奥氮平组和帕利哌酮组各53例。治疗后,帕利哌酮组患者的治疗总有效率为83.02%,显著高于奥氮平组患者的62.26%,差异有统计学意义(χ^(2)=5.744,P=0.017)。治疗前,两组患者的HAMD评分、HAMA评分和SCL-90评分比较,差异均无统计学意义(P>0.05);治疗后2周、4周和8周时,两组患者的HAMD评分、HAMA评分和SCL-90评分均显著低于本组治疗前,且帕利哌酮组患者治疗后各时点的HAMD评分、HAMA评分和SCL-90评分均低于奥氮平组,差异有统计学意义(P<0.05)。治疗期间,帕利哌酮组患者的不良反应总发生率为30.19%,显著低于奥氮平组患者的50.94%,差异有统计学意义(χ^(2)=4.735,P=0.030)。结论度洛西汀联合帕利哌酮治疗躯体形式障碍相比于度洛西汀联合奥氮平疗效更好,抑郁症状控制更加迅速,且安全性高,值得在临床推广使用。

Objective To investigate the efficacy and safety of duloxetine combined with paliperidone in the treatment of somatoform disorders.Methods The patients with somatoform disorders who were treated in the Third People's Hospital of Panzhihua City from July 2019 to October 2021 were selected and divided into olanzapine group and paliperidone group by random number table method.The patients in both groups were treated with Morita therapy-related psychotherapy by professional consultants.The olanzapine group was treated with duloxetine combined with olanzapine on the basis of psychotherapy,and the paliperidone group was treated with duloxetine combined with paliperidone.The curative effects of the two groups were compared,as well as the scores of Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)and symptom check list 90(SCL-90)were tested before and after 2,4 and 8 weeks of treatment,and the occurrence of adverse reactions in the two groups were compared.Results A total of 106 patients were included,including 53 patients in olanzapine group and 53 patients in paliperidone group.After treatment,the total effective rate in the paliperidone group was significantly higher than that in the olanzapine group(83.02%vs 62.26%,χ^(2)=5.744,P=0.017).Before treatment,there were no significant differences in the HAMD score,HAMA score and SCL-90 score between the two groups(P<0.05).At 2,4 and 8 weeks,the HAMD score,HAMA score and SCL-90 score in the two group were significant lower than those before treatment,and HAMD score,HAMA score and SCL-90 score of paliperidone group were lower than olanzapine group at all time point after treatment(P<0.05).During treatment,the total incidence of adverse reactions in the paliperidone group was significantly lower than that in the olanzapine group(30.19%vs 50.94%,χ^(2)=4.735,P=0.030).Conclusion Compared with duloxetine combined with olanzapine,duloxetine combined with paliperidone in the treatment of somatoform disorder has better efficacy,more rapid control of depressive symptoms,and high safety,which is worthy of clinical promotion.