氟伏沙明与氯米帕明治疗躯体化障碍的随机对照研究  

Control study of fluvoxamine versus clomipramine in treatment of somatization disorder

作　　者：吴胜[1] 唐丽[1] 罗捷[1] 

机构地区：[1]重庆市精神卫生中心,400036

出　　处：《四川精神卫生》2015年第5期417-419,共3页Sichuan Mental Health

摘　　要：目的评价氟伏沙明与氯米帕明对躯体化障碍的临床疗效和不良反应。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的92例躯体化障碍患者分为两组,分别给予氟伏沙明与氯米帕明治疗。氟伏沙明剂量(227.3±53.8)mg/d,氯米帕明剂量(205.5±32.7)mg/d。观察期8周。采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、副反应量表(TESS)评定疗效和不良反应。结果治疗8周后,氟伏沙明组与氯米帕明组总有效率比较差异无统计学意义(73.91%vs.69.57%,P>0.05);两组HAMA、HAMD总评分及躯体性焦虑因子评分均较治疗前低(P<0.05或0.01)。治疗2周末,氟伏沙明组HAMA评分及躯体性焦虑因子评分均较氯米帕明组低(P<0.05)。两组不良反应发生率比较差异有统计学意义(28.26%vs.60.87%,P<0.05)。结论氟伏沙明与氯米帕明治疗躯体化障碍疗效相当,氟伏沙明起效更快,不良反应更少。Objective To evaluate the clinical efficacy and safety of fluvoxamine and clomipramine in treatment of somatization disorder. Methods 92 patients according to CCMD - 3 criteria were enrolled in this study. 46 patients taking Fluvoxamine and anoth-er 46 patients having clomipramine for 8 weeks. The efficacy was evaluated by Hamilton Anxiety Scale(HAMA)and Hamilton Depres-sion Scale(HAMD),and safety was evaluated by Treatment Emergent Symptom Scale(TESS). Results After 8 weeks,fluvoxamine had similar efficacy to clomipramine(73. 91% vs. 69. 57% ,P > 0. 05),and the total scores of HAMD and HAMA,Somatic anxiety fac-tor scores were lower than before treatment(P < 0. 05 or 0. 01). At the end of 2nd week,the total scores of HAMA and Somatic anxiety factor score of fluvoxamine group were lower than clomipramine group. The adverse reaction of fluvoxamine were less and milder (28. 26% vs. 60. 87% ,P < 0. 05). Conclusion The efficacy of the two drugs is quite the same in treatment of somatization disorder. Fluvoxamine has rapid effect and fewer adverse reaction in the treatment.

关 键 词：氟伏沙明 氯米帕明 躯体化障碍 

分 类 号：R749[医药卫生—神经病学与精神病学]