度洛西汀及帕罗西汀治疗广泛性焦虑对照探究.docVIP

度洛西汀及帕罗西汀治疗广泛性焦虑对照探究 　【摘要】 目的 探讨度洛西汀与帕罗西汀治疗广泛性焦虑的临床疗效和安全性。 方法 将26例广泛性焦虑患者随机分为两组各13例，研究组口服度洛西汀胶囊治疗，对照组口服帕罗西汀治疗，观察6 w。于治疗前及治疗2 w、4 w、6 w末采用汉密顿焦虑量表和临床疗效总评量表的病情严重程度分量表评定临床疗效，副反应量表评定不良反应。 结果 两组治疗6 w末总有效率均为100%。治疗1 w末两组汉密顿焦虑量表总分均较治疗前有显著下降（P＜0.05或0.01），但研究组较对照组下降更显著（P＜0.05），随治疗时间的延续均呈持续性下降；两组治疗后临床疗效总评量表评分均较治疗前有显著下降（P＜0.01）；两组不良反应均较轻微。 结论 洛西汀治疗广泛性焦虑疗效显著，与帕罗西汀相当，但起效更快，安全性高，依从性好。 【关键词】 广泛性焦虑；度洛西汀；帕罗西汀；汉密顿焦虑量表；临床疗效总评量表 【Abstract】 ObjectiveTo explore the efficacy and safety of duloxetine and paroxetine in treatment of generalized anxiety disorder. Methods 26 patients with generalized anxiety disorder (GAD) were randomly assigned to research group(n=13) taking orally duloxetine and control group(n=13) doing paroxetine for 6 weeks. Curative effects were assessed with the Hamilton Anxiety Scale(HAMA) and the Clinical Global Impression(CGI) before treatment and at the ends of the 1th, 2nd,4th and 6th week treatment, adverse reactions with the Treatment Emergent Symptom Scale(TESS). Results After 6 week treatment, total effective rates of both groups were 100%. At the end of the 1st week, total scores of the HAMA of both groups lowered more significantly compared with pretreatment(Plt;0.05 or 0.01), that did more significantly in the research than in the control group(Plt;0.05), and those of both groups did continously following time of therapy lasting; scores of the CGI of both groups lowered more significantly after treatment(Plt;0.01); adverse raections of both groups were mild. Conclusion Duloxetine has evident effects equivalent to paroxetine,but takes effects more quickly and has higher safety and better compliance in the treatment of generalized anxiety disorder. 【Keywords】 Generalized anxiety disorder; duloxetine; paroxetine;HAMA;CGI 度洛西汀是一种5羟色胺(5HT)和去甲肾上腺素(NE)再摄取双重抑制剂(SNRI)，其作用机制与文拉法辛相同，但对NE再摄取抑制作用强于文拉法辛［1］。帕罗西汀是近年来临床上应用较多的一种选择性5HT回收抑制(SSRI)，与度洛西汀的作用机制不同。为此，我们应有度洛西汀与帕罗西汀治疗广泛性焦虑进行了随机对照研究，现报告如下。 1 对象与方法 1.1 对象 选取2008年3月～12月在我院治疗的广泛性焦虑患者为研究对象。入组标准：（1）符合《中国精神障碍分类与诊断标准