氟伏沙明治疗妇科癌症患者心理困扰的有效性的临床研究.doc

氟伏沙明治疗妇科癌症患者心理困扰的有效性的临床研究 Nao Suzuki, MD, PhD,* Masato Ninomiya, MD,? Tomoko Maruta, MD, ? Shinji Hosonuma, MD,* Norihito Yoshioka, MD, PhD,* Tatsuru Ohara, MD, PhD,* Yoshiko Nishigaya, MD, PhD, ? Yoichi Kobayashi, MD,* Kazushige Kiguchi, MD,* 和Bunpei Ishizuka, MD* 背景：癌症诊断引起心理困扰。本研究探讨了氟伏沙明治疗妇科癌症患者在癌症诊断后出现的适应障碍或严重抑郁的安全性和有效性。 方法： 选取2007年1月-2008年12月间入院的214例妇科癌症患者为筛选对象，在其得知患有癌症后至少2周，采用医院焦虑抑郁量表(HADS)，对其进行筛选。将HADS临界分数设为≥11分。10例患者签署了知情同意书，持续给予氟伏沙明8周。采用HADS和SF-36评价主要指标——氟伏沙明的安全性和有效性。测定次要指标——临床疗效总评量表。 结果：HADS总分、焦虑评分和抑郁评分分别在给药6周、4周和6周后显著降低。SF-36评价表明，给药8周后，在生命力、心理健康和角色（情感的）方面，均显著改善。给药4周后，在伴有适应障碍的5例患者中，仅HADS焦虑评分显著降低。在伴有严重抑郁的5例患者中， HADS总分、焦虑评分和抑郁评分分别在给药6周、8周、6周后显著降低。按照SF-36，给药8周后，适应障碍组在心理健康方面显示出显著改善，给药8周后，严重抑郁组在生命力和角色（情感的）方面显示出显著改善。受试者均无不良反应。临床疗效总评量表表明氟伏沙明有助于改善10例患者的心理困扰。 结论：本研究表明，氟伏沙明有助于减轻妇科癌症患者的心理困扰（包括适应障碍和严重抑郁）。诊断癌症后心理困扰的调节很重要。 关键词：氟伏沙明、医院焦虑抑郁量表、妇科癌症、选择性5羟色胺再摄取抑制剂、生活质量 Clinical Study on the Efficacy of Fluvoxamine for Psychological Distress in Gynecologic Cancer Patients Background: Diagnosis of cancer causes psychological distress. The present study investigated the safety and ef?cacy of ?uvoxamine therapy in gynecologic cancer patients with either adjustment disorder or major depression after cancer was diagnosed. Methods: Screening with the Hospital Anxiety and Depression Scale (HADS) was conducted at least 2 weeks after noti?cation of the diagnosis of cancer in 214 gynecologic cancer patients hospitalized between January 2007 and December 2008. The HADS cutoff score was set at 11 points or greater. Informed consent to the study was obtained from 10 patients, and ?uvoxamine was administered for 8 weeks. As primary end points, the safety and ef?cacy of ?uvoxamine were evaluated using the HADS and the SF-36. As a secondary end point, the Clinical Global Impression was determined. Results: The total HADS score, the anxiety score, and the depression score were signi?cantly reduced after 6, 4, and 6 weeks of treatment, respectively. The SF-36 revealed signi?cant i