奥氮平联合氟西汀与度洛西汀治疗躯体形式疼痛障碍的疗效比较  

Efficacy comparison between olanzapine-fluoxetine combination and duloxetine in treatment of somatoform pain disorder

作　　者：瞿伟[1] 谷珊珊[1] 罗菡[1] 唐倩影[1] 郭俊伟[1] 

机构地区：[1]第三军医大学西南医院临床心理科,重庆400038

出　　处：《第三军医大学学报》2012年第6期555-557,共3页Journal of Third Military Medical University

摘　　要：目的比较小剂量奥氮平联合氟西汀与度洛西汀治疗持续性躯体形式疼痛障碍疗效差异。方法临床病例对照研究设计。35例患者接受小剂量奥氮平联合氟西汀治疗(OFC组),33例患者接受度洛西汀治疗。2组患者完成急性治疗期12周的治疗。治疗前后观察指标:数字疼痛强度量表(PI-NRS)、临床疾病严重程度评定表(CGI-S)及临床总体疗效指数评分(CGI-EI)、汉密尔顿抑郁量表24项(HAMD-24)。观察评定时间分别于治疗前,治疗后1、2、4、8、12周末。结果 OFC组患者在治疗后第1周末及随后各时间观察点,PI-NRS显著低于度洛西汀组(P<0.05,P<0.01)、CGI-EI在各观察时间点则均明显高于度洛西汀组(P<0.01),2组患者在治疗后第1、2、4、8、12周末HAMD-24评分没有显著差异(P>0.05)。结论奥氮平联合氟西汀治疗躯体形式疼痛障碍在急性治疗期比单用度洛西汀疗效更优。Objective To compare the efficacy of olanzapine-fluoxetine combination（OFC） with duloxetine in treatment of persistent somatoform pain disorder.Methods A case-control study was performed.Thirty-five patients were treated with OFC（OFC group）,and other thirty-three patients were treated with duloxetine（duloxetine group）.All the patients were treated for 12 weeks（acute phase）.The indicators including scores of pain intensity-Numerical Rating Scale（PI-NRS）,Clinical Global Impression-Severity scale（CGI-S）,Clinical Global Impression-efficacy index（CGI-EI） and Hamilton Depression Rating Scale for Depression（HAMD-24） were used for evaluation before treatment and at the 1st,2nd,4th,8th and 12th weekends after treatment.Results At all time points after treatment,PI-NRS scores in the OFC group were significantly lower than those in the duloxetine group（P0.05,P0.01）,while CGI-EI scores were significantly higher in the OFC group than in the duloxetine group（P0.01）.There were no significant differences in HAMD-24 scores at different time points after treatment between the two groups（P0.05）.Conclusion The efficacy of OFC is better than that of duloxetine alone in the treatment of somatoform pain disorder at acute phase.

关 键 词：躯体形式疼痛障碍 氟西汀联合奥氮平 度洛西汀 疗效 

分 类 号：R749.2[医药卫生—神经病学与精神病学] R969.4[医药卫生—临床医学]