度洛西汀与氟西汀治疗躯体形式疼痛障碍对照研究

目的探讨度洛西汀与氟西汀治疗躯体形式疼痛障碍的临床疗效和安全性。方法将60例躯体形式疼痛障碍患者随机分为两组，每组30例，研究组口服度洛西汀治疗，对照组口服氟西汀治疗，观察8周。于治疗前及治疗第1周、2周、4周、6周、8周末采用医学结局研究用疼痛量表、汉密顿抑郁量表、汉密顿焦虑量表、副反应量表评定临床疗效及不良反应。结果研究组治疗第1周末起，对照组治疗第2周末起，医学结局研究用疼痛量表、汉密顿抑郁量表、汉密顿焦虑量表评分均较治疗前显著下降（P〈-．05或0．01），同期两组评分比较差异均无显著性（P〉0．05）；研究组起效时间显著早于对照组（t=18．71，P〈0．01）；治疗8周末，研究组有效率为83．3％，对照组为80．0％，两组比较差异无显著性（x2=0．11，P〉0．05）；两组不良反应均较轻微，发生率比较差异无显著性（P〉0．05）。结论度洛西汀与氟西汀治疗躯体形式疼痛障碍疗效显著且相当，安全性高，依从性好，但度洛西汀起效更快，更有利于提高患者的治疗依从性。

A control study of duloxetine vs.fluoxetine in the treatment of somatoform pain disorder

Objective To explore clinical effect and safety of duloxetine and fluoxetine in the treatment of somatoform pain disorder （SPD）. Methods Sixty SPD patients were randomly divided into two groups of 30 ones each, research group took orally duloxetine and control group did fluoxetine for 8 weeks. Clinical effects were assessed with the Medical Outcomes Study Pain Questionnaire （MOSPM）, Hamilton Depres- sion Scale （HAMD） and Hamilton Anxiety Scale （HAMA） at baseline and at the end of the 1st, 2nd, 4th, 6th and 8th week and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results The MOSPM, HAMD and HAMA scores in research group since the end of the 1st week and in control since 2nd lowered more significantly compared with pretreatment （P〈 0. 05 or 0. 01）, there were no significant differences in contemporaneous group comparisons （P〉0.05）; research group took effect more rapidly than control group did （t= 18. 71,P〈0.01）; at the end of the 8th week effective rate was respectively 83.3% in research and 80. 0% in control group, which showed no significant difference （x2 =0. 11 ,P〉 0.05）; adverse reactions of both groups were mild, their incidences had no significant group differences （P〉0.05）. Conclusion Duloxetine and fluoxetine have an evident and equivalent effect, higher safety anu better compliance in the treatment of SPD, but the former takes effect more rapidly and is beneficial to in- creasing patients＇ treatment compliance.