艾司西酞普兰与氟西汀治疗躯体形式障碍对照研究

目的 探讨艾司西酞普兰治疗躯体形式障碍的临床疗效及安全性.方法 将62例躯体形式障碍患者随机分为两组,每组31例.研究组口服艾司西酞普兰治疗,对照组口服氟西汀治疗,观察6周.于治疗前及治疗1周、2周、4周、6周末采用汉密顿焦虑量表及汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应.结果 治疗后两组汉密顿焦虑量表总分、汉密顿抑郁量表总分及焦虑/躯体化、认知障碍、阻滞、睡眠因子分均较治疗前有显著下降(P＜0.01);研究组治疗第1周末汉密顿焦虑量表总分、汉密顿抑郁量表总分及焦虑/躯体化、认知障碍、阻滞因子分均较对照组下降更显著(P＜0.05),其他时段评分两组差异均无显著性(P＞0.05).治疗6周末两组临床疗效比较差异无显著性(χ2=0.23,P＞0.05).两组不良反应均较轻微,治疗各时段两组副反应量表评分呈逐渐下降趋势,同期两组间比较差异均无显著性(P＞0.05).结论 艾司西酞普兰治疗躯体形式障碍疗效显著且与氟西汀相当,安全性高,能改善患者的焦虑、躯体化、认知障碍、阻滞、睡眠等症状,但艾司西酞普兰较氟西汀起效更快,更有利于提高患者的治疗依从性.

A control study of escitalopram vs fluoxetine in the treatment of somatoform disorders

Objective To explore the efficacy and safety of escitalopram in the treatment of somatoform disorders （SD）. Methods Sixty-two SD patients were randomly divided into two groups of 31 ones each, research group took orally escitalopram and control group did fluoxetine for 6 weeks. Efficacies were assessed with the Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1^st , 2^nd , 4^th and 6^th week. Results After treatment the total score of the HAMA and total, anxiety/somatization, cognitive disorder, blocking and sleep score of the HAMD of both groups lowered more significantly compared with pretreatment （P〈0.01） ; at the end of the 1^st week, the total score of the HAMA and total, anxiety/somatization, cognitive disorder, blocking score of the HAMD lowered more significantly in research group than in control （P〈0.05）, there were no significant differences in other periods scores （P〈0.05）. There was no significant difference in efficacy between two groups at the end of the 6^th week （χ^2=0.23,P〈0.05）. Adverse reactions of both groups were mild, the TESS scores in each period of treatment showed gradual downtrend, contemporaneous group comparisons had no significant differences （P〉0.05）. Conclusion Escitalopram equivalent to fluoxetine has an evident effect and higher safety and could improve symptoms such as anxiety, somatization, cognitive disorder, blocking, sleep and so on, but the former takes effect more rapidly and is more beneficial to improving patients＇ compliance.