度洛西汀与帕罗西汀治疗首诊广泛性焦虑症的对照研究

目的探讨度洛西汀与帕罗西汀治疗首诊广泛性焦虑症的临床疗效、安全性。方法将首诊的广泛性焦虑症患者随机分为两组,研究组口服度洛西汀治疗,对照组口服帕罗西汀治疗,观察8周疗效。于治疗前及治疗1周、2周、4周、8周末采用汉密尔顿焦虑量表(HAMA)和焦虑自评量表(SAS)评定临床疗效,副反应量表(TESS)评定不良反应。结果两组治疗8周末总有效率分别为度洛西汀组89.8%、帕罗西汀组87.2%。治疗1周末两组汉密尔顿焦虑量表总分均较治疗前有显著下降(P0.05或0.01),但研究组较对照组下降更显著(P0.05),随治疗时间的延续评分均呈持续性下降;两组治疗后汉密尔顿焦虑量表、焦虑自评量表总分均较治疗前有显著下降(P0.01);服药初期帕罗西汀不良反应较度洛西汀明显严重,影响治疗的依从性。结论度洛西汀治疗广泛性焦虑疗效与帕罗西汀相当,起效更快,安全性、依从性方面优于帕罗西汀。

Duloxetine and Paroxetine in the Treatment of First Diagnosed Generalized Anxiety Disorder

Objective To explore the clinical efficacy and safety of duloxetine and paroxetine in treatment of the Generalized Anxiety Disorder（GAD）.Methods 100 patients with GAD were randomly assigned to research group （n=50）taking orally duloxetine and con-trol group（n=50）doing paroxetine for 8 weeks.Curative effects were assessed with the Hamilton Anxiety Scale （HAMA）and the Anxiety Self-rating Scale（SAS）before treatment and at the ends of the 1th,2nd,4th and 8th week treatment.Adverse reactions were assessed with the Treatment Emergent Symptom Scale （TESS）.Results After 8 weeks treatment,total effective rates of duloxetine group and par-oxetine group were 89.8%and 87.2%respectively.At the end of the 1st week,total scores of the HAMA of both groups were significant-ly lowered compared with the scores before treatment （P〈0.05 or 0.01）.The decrease in the research group was more than that in the control group（P〈0.05）.The scores decreased continuously as time of therapy elapsed .Scores of the HAMA and SAS of both groups were significantly lowered after treatment（P〈0.01）.In the early stage of medication,adverse reactions of paroxetine were more serious than duloxetine ,and influenced the treatment compliance .Conclusion Duloxetine has evident equivalent effects to paroxetine , but it takes effects more quickly and has higher safety and better compliance than duloxetine in the treatment of GAD .