文拉法辛治疗躯体形式障碍对照探究.docVIP

文拉法辛治疗躯体形式障碍对照探究 　 作者：杨占宇 吕新华 刘建林 张文宝 【关键词】 躯体形式障碍；文拉发辛；阿米替林 　　【摘要】 目的 探讨文拉法辛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两组各35例，分别给予文拉法辛及阿米替林治疗。治疗前及治疗1、2、4、6w末采用汉密顿抑郁、焦虑量表评定临床疗效，同时检测各项辅助检查，并记录不良反应。 结果 显效率研究组优于对照组（χ2=4.05、Plt;0.05），总有效率差异无显著性（Pgt;0.05）。治疗后同期汉密顿抑郁、焦虑量表评分研究组均比对照组下降显著，差异有显著或极显著性（Plt;0.05或lt;0.01）；不良反应研究组程度较轻，多能自行缓解，对照组程度较重，需调整药物剂量或对症处理。 结论 文拉法辛治疗躯体形式障碍疗效显著，安全性高，依从性好，但高血压患者应慎用。 　　【关键词】 躯体形式障碍；文拉发辛；阿米替林 　　A control study of venlafaxine in the treatment of somatoform disorder 　　Yang Zhanyu, Lv Xinhua, Liu Jianlin, et al 　　(Kangning Hospital of Chaoyang City,122000, Liaoning, China) 　　【Abstract】 Objective To explore the clinical efficacy and safety of venlafaxine in the treatment of somatoform disorder.Methods 70 patients with somatoform disorder were randomly divided into venlafaxine(n=35) and amitriptyline(n=35) group. Clinical efficacies were assessed with the Hamilton Depression Scale(HAMD) and the Hamilton Anxiety Scale(HAMA). Side effects were recoded.Results Effectual rate was higher in the research than in the control group(Plt;0.05), and there was no significant difference in total effective rate between the 2 groups(Pgt;0.05). After treatment, scores of the HAMD and HAMA decreased more significantly in the research than in the control group, and differences were significant or the most significant(Plt;0.05 or 0.01); side effects in the research group were milder and could remit voluntarily, while those in the control group were severe and should be treated by adjusting dosage or symptomatic treatment.Conclusion Venlafaxine has better efficacy, higher safety and well compliance in the treatment of somatoform disorder, but to hypertensive patients should be used carefully. 　　【Keywords】 Somatoform disorder; venlafaxine; amitriptyline 躯体形式障碍是一类以各种躯体症状为主要表现，不能证实有器质性损害或明确的病理生理机制存在，但有证据表明与心理因素或内心冲突密切相关的精神障碍［1］。此病多就诊于综合医院，几经辗转才到精神科就诊，有关临床治疗的报导甚少。作者采用5羟色胺（5HT）和去甲肾上腺素（NE）再摄取抑制剂治疗躯体形式障碍并与阿米替林进行了对照研究，现报告如下。 　　1 对象与方法 　　1.1 对象 选取2004年6月～2005年6月首次在本院门诊就诊的70例躯体形式障碍为研