不同剂量度洛西汀治疗广泛性焦虑障碍的疗效与安全性  

Effect and safety of different doses of duloxetine in treating generalized anxiety disorder

作　　者：耿松[1] 朱毅平[1] 郭萍[1] 金学敏[1] 杨胜良[1] 

机构地区：[1]湖州市第三人民医院心身障碍科,浙江湖州313000

出　　处：《中国新药与临床杂志》2015年第11期839-842,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨不同剂量度洛西汀治疗广泛性焦虑障碍（GAD）的疗效与安全性。方法选择符合ICD-10诊断标准的GAD住院或门诊患者，随机分为度洛西汀60mg·d-1（A组）、90mg·d-1（B组）、120mg·d-1（C组）和帕罗西汀组（D组），每组各40例。度洛西汀组开始均口服度洛西汀30mg·d-1，并逐渐增加到目标剂量，D组口服帕罗西汀10mg·d-1，渐增加到个体所需量，失眠患者睡前服唑吡坦。治疗后第1、2、4、8周末，评定汉密尔顿焦虑量表（HAMA）。入组时及第8周末查心电图，血、尿常规，肝、肾功能。结果A、B、C、D四组患者实际完成研究分别为35、33、34、35例，D组帕罗西汀平均剂量为（32．2±8．4）mg·d-1。治疗后第2周末B、C组HAMA得分开始低于A、D组，并一直持续到第8周末（P〈0．05或P〈0．01）。度洛西汀90、120mg·d-1对GAD症状的改善优于度洛西汀60mg·d-1和帕罗西汀（P〈0．05）。四组的治愈率分别为47％、55％、59％、46％，有效率分别为75％、85％、85％、74％，组间比较均无显著差异（P〉0．05）。四组不良反应出现率无显著意义（P〉0．05）。结论度洛西汀治疗GAD疗效确切且安全，90～120mg·d-1对GAD症状的改善优于度洛西汀60mg·d-1与帕罗西汀。AIM To research the effect and safety of different doses of duloxetine in treating patients with generalized anxiety disorder （GAD）. METHODS Those hospitalized and outpatients with GAD were selected. They were randomly divided into group A treated with duloxetine 60 mg. d-1, group B treated with duloxetine 90 mg.d-1, group C treated with duloxetine 120 mg.d-1 and group D treated with paroxitinte （40 patients in each group）. Patients with sleep disturbances were allowed to take zolpidem. At the end of the 1st, 2nd, 4th and 8th week, the evaluations were taken with Hamilton Anxiety Scale （HAMA）. Electrocardiogram, blood routine, urine routine, liver function and kidney routine were checked before the research and at the end of the8th week. RESULTS The actual number of those completing the experiment in each group was 35 in the group A, 33 in group B, 34 in group C and 35 in group D. The average dose of paroxitinte was （32.2 ± 8.4） mg.d-1. The HAMA scores in the group B and C began to be lower than those in the group A and D at the end of the 2nd week, lasting till the end of 8th week （P 〈 0.05 or P 〈 0.01）. As was shown, the effect of duloxetine 90 and 120 mg.d-1 on GAD was superior to duloxetine 60 mg.d-1 and paroxitinte （P 〈 0.05）. The final cure rates in the group A were 47% with its effective rate 75%, 55% in the group B with its effective rate 85%, 59% in the group C with its effective rate 85% and 55% in the group D with its effective rate 74%. The final clinical cure rates in the four groups were almost equal （P 〉 0.05）. The four groups had the common adverse reaction, which had no statistic meaning （P 〉 0.05）. CONCLUSION The effects of duloxetine in treating patients with GAD is sure and safe and duloxetine 90 and 120 mg.d-1 on GAD is superior to duloxetine 60 mg.d-1 and paroxitinte.

关 键 词：焦虑症 抗焦虑药 度洛西汀 帕罗西汀 

分 类 号：R964[医药卫生—药理学]