艾司西酞普兰与帕罗西汀治疗伴有焦虑症状抑郁障碍的对照研究

目的：研究艾司西酞普兰与帕罗西汀治疗伴有焦虑症状抑郁障碍的疗效及安全性。方法：将64例伴焦虑症状的抑郁障碍患者随机进人艾司西酞普兰组（n=32）或帕罗西汀组（n=32）接受为期6周治疗，分别在治疗第0、1、2、4、6周末以《汉米尔顿抑郁量表一17》（HamiltonDepressionRatingScaleforDepression一17，HRSD）及《汉米尔顿焦虑量表》（HamiltonAnxietyScale，HAMA）总分评估患者疗效，以《药物副反应量表》（TreatmentEmergentSymptomScal，TESS）评估患者的药物不良反应。脱落患者数据视为不可用，不予统计。结果：经过6周的治疗，艾司西酞普兰组脱落1例，帕罗西汀组脱落2例，两者之间无明显差异（P〉0．05）。艾司西酞普兰组有效率和治愈率分别是83．9％（26例）和58．1％（18例）。帕罗西汀组有效率和治愈率分别是76．7％（23例）和56．7％（17例），两组无明显差异（P〉0．05）。治疗第1、2周末艾司西酞普兰组HAMD量表总分改善明显好于帕罗西汀组（P〈O．01），第4周、第6周则无明显差异（P〉0．05）。治疗第1周HAMA量表艾司西酞普兰组总分好于帕罗西汀组（P〈0．05）。不良反应艾司西酞普兰组明显少于帕罗西汀组（x2值=14．93；P值〈0．001）。结论：艾司西酞普兰与帕罗西汀疗效相当，艾司西酞普兰起效较快，早期即有明确的抗抑郁及焦虑作用；且不良反应发生率低。

Comparison study of Escitalopram vs Paroxetine in the treatment of depressive disorder with anxiety

Objective：To evaluate the efficacy and safety of Escitalopram vs Paroxetine in the treatment of depressive disorder with anxiety. Methods：This was an 6 weeks randomized control study. Totally 64 patients were randomly assigned to Escitalopram group （ n = 32） or Paroxetin group （ n = 32）. Clinical efficacies were assessed with the Hamilton Depression Scale （HRSD） and Hamilton Anxiety Scale （HAMA）. adverse actions with the Treatment Emergent Symptom Scale （TESS） before and at the end of the 1 st,2nd ,4th and 6th week treatment. Results： The 6 - week drop in Escitalopram group was lower than that in Paroxetine group （ 1 VS. 2, P 〉 0. 05） ,which showed no significant difference. In patients who completed 6 - week trial,the difference of symptom improvement rate be- tween Escitalopram group and Paroxetin group was not statistically significant（ P 〉 0.05 ）. Analysis showed that at the end of 6 - weeks observation,there was no statistically difference in efficacy between the two groups. But Escitalopram group showed earlier improvement in depressive symptoms and Anxiety symptoms than Paroxetine group. （ HRSD score at the end of the lth week and 2nd week, （ 16.24±3.82） VS （20.72± 3.16）, P 〈 0.01, （ 13.3 ± 5.4） VS （ 17.1 ±6.3）, P 〈 0.01 ; HAMA score at the end of the 1 th week, （ 13.14 ± 5.4） VS （ 14.8 ± 6.1 ） ,P 〈 0.05 ） , and lower adverse reactions than Paroxetine group （ 12VS26, x2 = 14.93, P 〈 O. 001 ）. Conclu- sions： Both Escitalopram and Paroxetine have same efficacy. Escitalopram in the treatment of depressive disorder with anxiety may have better efficacy and tolerance than Paroxetine.