帕罗西汀与谷维素治疗肝硬化患者伴发抑郁焦虑症状的效果对比

目的比较帕罗西汀、谷维素对肝硬化患者伴发抑郁焦虑症状的治疗效果。方法收集2004年3月至2004年9月瑞金医院消化内科病房收治的肝硬化患者中汉密顿抑郁量表(HAMD)>12分且汉密顿焦虑量表(HAMA)>10分者30例,随机分为帕罗西汀组(10 mg,po,qd)和谷维素组(2片,po,tid),每组15例,疗程6 wk。在治疗的2、4、6 wk分别以HAMD、HAMA、症状自评量表(CSL-90)、生活满意度指数评定及实验室测定肝功能、PT、APTT。结果2组治疗后2、4、6 wk的SCL-90、HAMD、HAMA评分均低于治疗前,生活满意度指数均高于治疗前(P<0．05);6 wk复查,帕罗西汀组SCL-90、HAMD评分均低于谷维素组(P<0．01和<0．05);2和6 wk复查,帕罗西汀组HAMA评分低于谷维素组;4和6 wk复查,帕罗西汀组生活满意度指数高于谷维素组(P<0．01和<0．05);帕罗西汀与谷维素治疗前后肝功能各项指标、PT、APTT无变化(P>0．05)。结论帕罗西汀能够快速有效治疗肝硬化伴发的抑郁焦虑症状,无明显肝功能损害,其疗效优于谷维素。

Efficacy of paroxetine in treatment of cirrhosis patients with depression-anxiety neurosis

AIM To compare the curative effect of paroxetine and oryzanol of the cirrhosis in patients of cirrhosis with depression-anxiety neurosis. METHODS From Mar. 2004 to Sep. 2004,30 cirrhosis patients from those who were hospitalized in Ruijin hospital confirmed by Hamilton rating scale for depression (HAMD) and Hamilton rating scale for anxiety(HAMA)were enrolled.Then all the 30 patients were randomly divided into paroxetine group and oryzanol group, each group had 15 patients, to evaluate the grades of their Symptom Checklist (SCL-90), HAMA, HAMD and quality of life and meanwhile to evaluate the hepatic function, PT and APTT. The patients of paroxetine group were administrated paroxetine (10 mg,po,qd)and the patients of oryzanol group were administrated oryzanol (2 tablets, po , qd) for 6 wk.At 2,4 and 6 wk follow-up,the above rating scales and lab results were evaluated and compared. RESULTS (1)The scores of SCL-90, HAMD and HAMA were significantly reduced after paroxetine or oryzanol administration at 2,4 and 6 wk in both groups, while the scores of the quality of life were significantly increased: At the 6 wk follow-up, the scores of CSL-90 and HAMD by paroxetine group were lower than those by oryzanol group and had statistical difference; At the 2 and 6 wk follow-up, the scores of HAMA by paroxetine group were lower than those by oryzanol group and had statistical difference ; At the 4 and 6 wk follow-up, the scores of quality of life by paroxetine group were higher than those by oryzanol group and had statistical difference. (2) There was no significant difference in both groups for the hepatic function, PT and APTT before and after the treatment. CONCLUSION Paroxetine therapy can relieve the symptom of the cirrhosis patients with depression-anxiety neurosis,it has no inverse effect on hepatic function lesions and its curative effects are better than oryzanol.