度洛西汀与帕罗西汀治疗伴有疼痛的广泛性焦虑障碍的疗效比较

目的：对比度洛西汀和帕罗西汀对伴有疼痛的广泛性焦虑障碍的疗效和安全性。方法：筛选伴有明显疼痛的广泛性焦虑障碍患者87例，随机分为两组，分别予以度洛西汀60mg／d和帕罗西汀20mg／d治疗。治疗前后分别测试疼痛视觉模拟量表（VAS）、汉密尔顿焦虑量表（HAMA）、不良反应量表（TESS），同时监测血压、心电图和肝肾功能。结果：度洛西汀组治疗后2周、4周和6周的VAS评分较治疗前明显下降，差异有统计学意义（P〈0．05或P〈0．01），帕罗西汀组治疗后4周、6周VAS评分较治疗前下降，差异有统计学意义（P〈0．01）；度洛西汀组VAS评分在治疗2周、4周和6周时均低于帕罗西汀组（P〈0．05）。治疗2周和4周时，度洛西汀组HAMA总分和HAMA躯体性焦虑因子分明显低于帕罗西汀组（P〈0．05），治疗6周时两组HAMA总分差异无统计学意义（P〉0．05）。度洛西汀组和帕罗西汀组对焦虑治疗的有效率分别为60．98％和58．54％（P〉0．05），痊愈率分别为34．15％和26．83％（P〉0．05）。结论：度洛西汀对伴有疼痛的广泛性焦虑障碍的疗效和安全性与帕罗西汀相当，但对焦虑和疼痛起效更快，对疼痛效果更好。

Comparison of curative effect of duloxetine and paroxetine in treatment of generalized anxiety disorder with pain

Objective： To evaluate the efficacy and safety of duloxetine and paroxetine in the treatment of generalized anxiety disorder with pain. Methods： Eighty seven patients were randomized into two groups. Forty four patients in duloxetine group were administered with duloxetine 60 mg/day and forty three patients in paroxetine group were treated with paroxetine 20 mg/day for 6 weeks. Efficacy were assessed with Visual Analogue Scale （VAS） for pain, Hamilton Anxiety Scale （HAMA） for anxiety, and Treatment Emergent Symptom Scale （TESS） for side effect. Results： As the duration of treatment, the VAS scores in the both groups were reduced significantly than that before treatment. At the end of 2, 4, 6 weeks after treatment, the VAS scores in duloxetine group were lower significantly than that in paroxetine group （P〈0.05）. The scores of HAMA and HAMA-somatic in duloxetine group were reduced significantly at the end of 2, 4 weeks after treatment than that in paloxetine group （P〈0.05）. The effective rate of treating the anxiety were 60.98% and 58.54% （P〉0.05）, and the recovery rate were 34.15% and 26.83% （P〉0.05） in duloxetine group and paroxetine group, respectively. Conclusion： Duloxetine is an effective and safe antidepresent as paroxetine in treatment of generalized anxiety disorder with pain. Duloxetine is more effective against pain, and work faster than paroxetine in aspect of anxiety and pain.