文拉法辛与西酞普兰治疗躯体形式疼痛障碍对照研究

目的探讨文拉法辛与西酞普兰治疗躯体形式疼痛障碍的临床疗效及安全性。方法将63例躯体形式疼痛障碍患者随机分为研究组32例，对照组31例，研究组口服文拉法辛治疗，对照组口服西酞普兰治疗，观察6w。于治疗前及治疗2w、4w、6w末采用疼痛量表评定疼痛状况，汉密顿抑郁量表评定抑郁状况，副反应量表评定不良反应。结果治疗6w末，研究组疼痛缓解率为71．88％，抑郁情绪改善率93．75％；对照组分别为67．74％、90．32％，两组无显著性差异（P〉0．05）。研究组治疗2W末起疼痛量表疼痛严重程度因子分较治疗前显著降低（P〈0．01），对照组治疗4w末较治疗前显著下降（P〈0．01）。对照组治疗2w末起汉密顿抑郁量表认知障碍因子分较治疗前显著下降（P〈0．01），研究组治疗4w末较治疗前显著降低（P〈0．01）。结论文拉法辛与西酞普兰治疗躯体形式疼痛障碍、改善抑郁情绪总体疗效相当，但文拉法辛在缓解疼痛严重程度方面起效较快，而西酞普兰在改善认知障碍方面起效较快。

A control study of venlafaxine vs citalopram in the treatment of somatoform pain

Objective To explore the clinical efficacy and safety of venlafaxine vs citalopram in the treatment of persistent somatoform pain disorder. Methods 63 patients with somatoform pain disorder were randomly divided into research group（n=32） took orally venlafaxine and control group（n=31） did citalopram for 6 weeks. Before treatment and atthe end of the 2nd,4th and 6th week, pain conditons were assessed with the Medical Outcomes Study Pain Measurement （MOSPM）, depression conditions with the Hamilton Depression Scale （HAMD）, and adverse effects with the Treatment Emergent- Symptom Scale （TESS）. Results At the end of the 6th week, pain relieving rate and improvement rate of depressed emotion were respectively 71.88% and 93.75% in the research and 67.74% and 90. 32% in the control group, which showed no significant differences（P〉0.05）. Compared with pretreatment, scores of pain severity of the MOSPM lowered more significantly since the end of the 2nd week in the research（P〈0.01） and since the end of the 4th week in the control group（P〈0.01）. Compared with pretreatment, scores of cognitive disorder of the HAMA lowered more significantly since the end of the 2nd week in the control（P~0.01） and since the end of the 4th week in the research group（P〈0.01）. Conclusion Total efficacies of venlafaxine and citalopram are equivalent in treatment of somatoform pain disorder and improvement of depressed emotion,but the former takes effect faster in pain relieving and the latter in improvement of cognitive disorder.