艾司西酞普兰治疗持续性躯体形式疼痛障碍的随机对照研究

目的 研究艾司西酞普兰治疗持续性躯体形式疼痛障碍的疗效和安全性.方法 采用随机对照、开放性设计,将门诊接受治疗的持续性躯体形式疼痛障碍患者随机分为两组,即治疗组(艾司西酞普兰组)40例,对照组(文拉法辛缓释剂组)40例,疗程6周,于治疗前及治疗后第1,2,4,6周末进行疗效评定,以汉密尔顿抑郁量表(HAMD)汉密尔顿焦虑量表(HAMA)减分情况评定疗效,不良反应症状量表(TESS)评定不良反应.结果 艾司西酞普兰与文拉法辛缓释剂治疗持续性躯体形式疼痛障碍均有疗效.治疗组与对照组的自觉症状缓解时间均缩短,临床疗效明显.HAMD,HAMA评分差异均无统计学意义.两组治疗6周后有效率(以减分率≥50％为标准)分别为:治疗组80％,对照组85％,P＞0.05.两组不良反应在第1周末对照组评分高于治疗组,两组差异有统计学意义(P＜0.01).结论 持续性躯体形式疼痛障碍患者多存在焦虑抑郁情绪,而使用艾司西酞普兰10 mg/d起效快,不良反应发生率低,安全性良好.

a randomized controlled trial AI escitalopram in treatment of persistent somatoform pain disorder

OBJECTIVE To study the efficacy and safety of AI escitalopram in treatment of persistent somatoform pain disorder.METHODS A randomized,open design and out-patient in treatment of persistent somatoform pain disorder patients were randomly divided into two groups.40 cases in the treatment group(escitalopram),and 40 cases in the control group(venlafaxine),the course of treatment was 6 weeks.The treatment efficacy was assessed before and after treatment at the time of first,second,fourth and sixth weekends.The Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),side effects symptoms scale(TESS)were used to assess the efficacy.RESULTS The escitalopram and venlafaxine therapy has efficacy in treatment of persistent somatoform pain disorder.The remission times of consciously symptoms in the experimental and control groups were shortened,and the clinical efficacy was obvious.HAMD and HAMA score did not show significant difference.The efficacy rate of the two groups within 6 weeks were(to reduce fraction = 50% of the standard):80% in the treated groups,and 85% inthe control group,P﹥0.05.The adverse reaction scores in the first weekend of the control Group were significantly higher than those of the treatment group,and there was significant difference between the two groups(P﹤0.01).CONCLUSION The persistent somatoform pain disorder still existed in patients with depression and anxiety,but AI escitalopram with 10 mg/day has fast,low incidence of adverse reactions,and better security.