文拉法辛缓释剂和氟西汀治疗首发抑郁症的对照研究  

A parallel control study of venlafaxine and fluoxertine in first-episode patients with depression

作　　者：江开达[1] 苏晖[1] 徐一峰[1] 李飞[1] 刘晓华[1] 刘义兰[1] 潘桂花[1] 

机构地区：[1]上海市精神卫生中心,200030

出　　处：《上海精神医学》2007年第1期15-18,共4页Shanghai Archives of Psychiatry

摘　　要：目的比较文拉法辛缓释剂和盐酸氟西汀治疗抑郁症首发患者的急性期疗效、安全性和依从性。方法采用前瞻性平行对照研究方法,184抑郁发作患者分别进行文拉法辛缓释剂和盐酸氟西汀治疗。文拉法辛组93例,平均剂量(99.41±38.72)毫克/天;氟西汀组91例,平均剂量(20.24±2.17)毫克/天,治疗8周。采用17项汉密尔顿抑郁量表(HAMD17)评价症状严重程度,治疗时出现的症状量表(Treatment Emergent Symptom Scale,TESS)评定不良反应,社会功能缺陷筛选量表(Social Disability Screening Schedule,SDSS)评价社会功能。结果(1)第6周文拉法辛组有效率(69.89%)和治愈率(31.18%)明显高于氟西汀组的[(53.85%)和(16.48%)](P<0.05)。第8周文拉法辛有效率为(77.42%)、缓解率(44.09%),氟西汀组有效率为(68.13%)、缓解率(36.26%),两组疗效差异无显著意义(P>0.05)。文拉法辛组SDSS评分为(1.63±2.98)分,氟西汀组为(1.69±2.70)分(P>0.05)。(2)文拉法辛组和氟西汀组与药物有关的不良反应出现频率的差异无统计学意义(P>0.05)。(3)文拉法辛组和氟西汀组脱落率(12.90%vs.17.58%)的差异无统计学意义(P>0.05)。结论文拉法辛和氟西汀治疗抑郁症首发患者的急性期疗效确切,第6周文拉法辛组有效率和治愈率明显高于氟西汀组,两组药物的不良反应和依从性相当。Objective： To compare the effectiveness, safety and compliance of venlafaxine extended release and fluoxertine hydrochloride in outpatients with first episode depression. Methods： Total 184 cases of first -episode depressive outpatient were admitted and assigned to receive either venlafaxine extended release （venlafaxine XR） （n = 93 ） or fluoxertine hydrochloride （n = 91 ） by a parallel control prospective study. The treatment was 8 weeks, and Disease Severity was assessed by Hamilton Rating Scale for Depression （HAMD）17 item. Using Treatment Emergent Symptom Scale （TESS） for evaluating adverse events, and Social Disability Screening Schedule（SDSS） for social disability. Results： （1） At week 6, the response rate （69.89%）and remission rate （ 31.18% ） of venlafaxine XR group were higher than those of fluoxertine hydrochloride group [ （53.85%） and （ 16.48% ） ] （ P 〈 0.05 ） ; At week 8 , the response rate and the remission rate of venlafaxine XR group was 77.42% and 44.09 %, and fluoxertine hydrochloride group had a response rate of 68.13%, and the remission rate is 36.26%, there was no statistical difference between the two groups （ P 〉 0.05 ）. At week 8, the SDSS scores of venlafaxine XR group and fluoxertine hydrochloride group were [ （1.63 ± 2.98 ）scores vs. （ 1.69 ± 2.70） score ] （ P 〉 0.05 ）. （ 2 ） The comparison of the adverse events frenquence rates of venlafaxine group and fluoxertine hydrochloride group had no differeneial meaning（P 〉0. 05） （3） The discontinued rates of venlafaxine XR group and fluoxertine hydrochloride group （ 12.90% vs. 17.58 % ） were not statistical difference（P 〉 0. 05 ）. Conclusion： Venlafaxine extended release and fluoxertine hydrochloride have similar therapeutic efficacy, and at week 6 venlafaxine XR has higher response rate and remission rate. Both two drugs have good safety and compliance in treating first episode depression outpatients.

关 键 词：首发 抑郁障碍 文拉法辛 盐酸氟西汀 疗效 依从性 不良反应 

分 类 号：R749.4[医药卫生—神经病学与精神病学]