文拉法辛缓释剂与氟西汀治疗抑郁症首次发病患者的对照研究

目的：探讨文拉法辛缓释剂治疗抑郁症首次发病（以下称首发）患者的有效性及安全性。方法：采用随机、单盲对照法，将80例抑郁症首发患者分为文拉法辛组（75～225mg／d）和氟西汀组（20～40mg／d），疗程均为8周。治疗前后以汉密尔顿抑郁量表（17项，HAMD）评估疗效，记录不良反应及实验室情况。结果：实际完成80例，其中文拉法辛组40例，氟西汀组40例。治疗第2周末，文拉法辛组的HAMD总分较治疗前明显下降（t=6．47，P＜O．01）．减分率高于氟西汀组（x^2=10．05．P＜0．01）。氟西汀组HAMD总分在治疗第4周末较治疗前明显下降（忙8．097，P＜0．01）。治疗第2，4周末，文拉法辛组有效率分别为17．5％和54．8％，氟西汀组分别为2．5％和25％，组问差异均有统计学意义（x^2=12．5，P＜0．0l；x^2=18．5l，P＜0．01）。治疗第6，8周末，文拉法辛组治愈率分别为40％和62．5％，氟西汀组分别为22．5％和47．5％，组问差异均有统计学意义（x^2=6．336，P＜0．05；x^2=4．45，P＜0．05）；而两组有效率的差异无统计学意义（x^2=1．681；x^2=0．866，P＞0．05）。两组患者出现药物不良反应12例和13例（分别占30％和32．5％），差异无统计学意义（x^2=0．144，P＞0．05）。结论：文拉法辛缓释剂治疗抑郁症首发患者起效较快、安全、疗效肯定，治疗第6，8周末时治愈率高于氟西汀。

The efficacy and tolerability of venlafaxine and fluoxetine in treatment of patients with first-episode depression

Objective:To study the efficacy and tolerability of venlafaxine as compared with fluoxetine in treating the patients with first-episode depression.Methods:A random,single blind study was conducted in 80 first-episode depressive patients.Patients were assigned to receiving venlafaxine(75~225 mg/d) or fluoxetine(20~40 mg/d) treatment for 8 weeks.The efficacy was evaluated with the Hamiton Rating Scale for Depression(HAMD),and the side effects and laboratory test data were recorded as well.Results: 80 cases were finisied the study.At the end of the 2nd week,significantly more HAMD score reduction was in venlafaxine group than in fluoxetine group.At the end of the 2nd and 4th week,the remission rates were 17.5% and 54.8%in venlafaxine group,which were significantly higher than that(2.5%and 25%) in fluoxetine group(x~2=12.5,P<0.01;x~2=18.51,P<0.01).At the end of the 6th and 8th weeks,the remission rate in venlafaxine group were 39% and 61%,which in fluoxetine group were 22.5%and 47.5% respectively(x~2=6.336,P<0.05;x~2=4.45,P<0.05).Both group had mild adverse effects(x~2=0.144,P>0.05).Conclusions: Venlafaxine is effective and safe in the treatment of the depression patients.