文拉法辛与帕罗西汀治疗躯体形式障碍对照研究

目的探讨文拉法辛与帕罗西汀治疗躯体形式障碍的临床疗效及安全性。方法将70例躯体形式障碍患者随机分为研究组30例和对照组40例，研究组口服文拉法辛治疗，对照组口服帕罗西汀治疗，在此基础上两组均给予支持性心理治疗及生物反馈治疗，观察8w。于治疗前及治疗1w、2w、4w、8w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果治疗8w末，研究组与对照组抗焦虑显效率分别为86．7％和70．0％，抗抑郁显效率分别为90．0％和82．0％（χ^2=2．70，0．79，P〉0．05）；汉密顿焦虑量表、汉密顿抑郁量表评分，两组治疗1w末起均较治疗前有显著下降（P〈0．01），并随治疗时间的延续均呈持续性下降。同期两组间比较均无显著性差异（P〉0．05），两组不良反应均轻微（P〉0．05）。结论文拉法辛与帕罗西汀治疗躯体形式障碍疗效肯定，不良反应轻微，安全性高，依从性好。

A control study of venlafaxine and paroxetine in somatoform disorders

Objective To explore the efficacy and safety of venlafaxine and paroxetine in somatoform disorders. Methods TBZW70 patients with somatoform disorders were randomly assigned to research （n=30） control group （n = 40）, both groups received supportive psychotherapy and biofeedback therapy, the former was plus venlafaxine and the latter plus paroxetine for 8 weeks. Curative effects were assessed with Hamilton Anxiety Scale（HAMA） and the Hamilton Depression Scale（HAMD） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of the 1^st ,2^nd ,3^rd ,4^th and 8^th week treatment. Results At the end of the 8^th week, antianxiety and antidepression exellence rates were 86.7% and 90.0% in the research and 70.0% and 82.0% in the control group respectively（P〉0.05） ; the HAMA and HAMD scores of both groups lowered more significantly since the end of the 1st week compared with pretreatment（P〈0.01） and did continously along with therapy lasting; there was no significant difference in synchronaztion intergroup comparison（P〉0.05）; the adverse reactions of both groups were milder（P〉0.05）. Conclusion Both venlafaxine and paroxetine have positive efficacy,milder adverse reactions, higher safety and better compliance in somatoform disorders.