度洛西汀与阿普唑仑治疗广泛性焦虑症对照研究

目的 评价度洛西汀与阿普唑仑治疗广泛性焦虑症的临床疗效和安全性.方法 将90例广泛性焦虑症患者随机分为两组,每组45例,研究组口服度洛西汀治疗,对照口服阿普唑仑治疗,观察6周.于治疗前及治疗第1周、2周、4周、6周末采用焦虑自评量表及汉密顿焦虑量表评定临床疗效,副反应量表评定不良反应.结果 治疗后两组焦虑自评量表及汉密顿焦虑量表评分均较治疗前显著下降(P＜0.01),治疗6周末,研究组显效率60.0%、有效率84.4%,对照组分别为55.6%、82.2%,两组比较差异无显著性(P＞0.05).研究组不良反应发生率为28.9%,对照组为40.0%,两组差异无显著性(P＞0.05);两组不良反应均较轻微,多出现在治疗初期,患者均能耐受,随着治疗的延续均可逐渐减轻或缓解.结论 度洛西汀有较强的抗焦虑作用,治疗广泛性焦虑症疗效显著,总体疗效与阿普唑仑相当,安全性高,依从性好,可作为治疗广泛性焦虑症的一线用药.

A control study of duloxetine vs alprazolam in the treatment of generalized anxiety disorder

Objective To evaluate the efficacy and safety of duloxetine and alprazolam in the treatment of generalized anxiety disorder （GAD）. Methods Ninety GAD patients were randomly assigned to two groups of 45 ones each, research group took orally duloxetine and control group did alprazolam for 6 weeks. Efficacies were assessed with the Self rating Anxiety Scale （SAS） and Hamilton Anxiety Scale （HAMA） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1^st, 2^nd, 4^th and 6^th week. Results The SAS and HAMA scores of both groups low- ered more significantly after treatment compared with pretreatment （P〈0.01） ; at the end of the 6^th week, obvious effective and effective rate were 60.0% and 84.4% in research group and 55.6%and 82.2% in control, respectively, which showed no significant differences （P〈0.05）. The incidences of adverse reactions were respectively 28.9~ in research group and 40.0% in control, which showed no significant differences （P〈0.05） ; adverse reactionsof both groups were mild, the most occurred in the early days of treat rnent, were well-tolerated, and could lessened or relieved gradually with treatment. Conclusion Duloxe tine has a stronger anti-anxious action and an evident effect on GAD, its total efficacy is equivalent to alprazolam, it has higher safety and better compliance, and could be used as first line drug for generalized anxiety disorder.