度洛西汀联合认知疗法治疗持续性躯体形式疼痛障碍对照研究  

A control study of duloxetine plus cognitive therapy in persistent somatoform pain disorder

作　　者：崔春青[1] 李素敏[2] 侯拥军 邹振民[1] 李学灵[1] 耿寒松[1] 刘力军[1] 祖国辉[1] 

机构地区：[1]河北省荣军医院,河北保定071000 [2]中国人民解放军第305医院,中国北京100017 [3]保定新生医院,河北保定071000

出　　处：《临床心身疾病杂志》2016年第2期30-32,35,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨度洛西汀联合认知疗法治疗持续性躯体形式疼痛障碍的临床疗效。方法将106例持续性躯体形式疼痛障碍患者按入组顺序编号分为两组，每组53例，均予以口服度洛西汀治疗，研究组在此基础上联合认知疗法治疗，观察8周。治疗前后采用汉密顿抑郁量表评定抑郁状况，医学结局研究用疼痛量表评定疼痛状态。结果研究组治疗第4周末汉密顿抑郁量表总分、认知因子分和第8周末认知因子分均显著低于对照组（P〈0．01），治疗各时点医学结局研究用疼痛量表总分及疼痛严重程度分均显著低于对照组（P〈0．05或0．01）；治疗第4周末研究组有效率（49．1％）显著高于对照组（26．0％）（X2=5．81，P〈0．05），治疗第8周末两组痊愈率、有效率比较差异均无显著性（X2=0．13、0．11，P〉O．05）。结论度洛西汀联合认知疗法治疗持续性躯体形式疼痛障碍具有协同增效作用，能有效缓解患者的躯体化疼痛症状和情感症状，较单用度洛西汀治疗起效更快，值得临床推广应用。Objective To explore the efficacy of duloxetine plus cognitive therapy （CT） in persistent somatoform pain disorder （PSPD）. Methods A total of 106 PSPD patients were assigned to two groups of 53 ones each according enrolment order, both groups took orally duloxetine, and research group was plus CT for 8 weeks. Depression states were assessed with the Hamilton Depression Scale （HAMD） before and after treatment and pain with the Medical Outcomes Study Pain Measurement （MOSPM）. Results The total and cognition score of the HAMD at the end of the 4th week and cognition at the 8th （P〈0.01） as well as the total and pain severity of the MOSPM at each time-point （P〈0. 05 or 0.01） were significantly lower in research than in control group; the effective rate was significantly higher in research than in control group at the end of the 4th week （49.1% vs. 26.0%, X2=5.81,P〈0.05）, there were no significant group differences in recovery and effective rate at the 4th（x2=0. 13, 0. 11; P〉0. 05）. Conclusion Duloxetine combined with cognitive therapy has a synergism in PSPD, could effectively relieve patients＇ somatoform pain affective symptoms, takes effect more quickly compared with single duloxetine, and deserves clinical generalization and application.

关 键 词：持续性躯体形式疼痛障碍 心身疾病 度洛西汀 认知疗法 医学结局研究用疼痛量表 汉密顿抑郁量表 

分 类 号：R749.7[医药卫生—神经病学与精神病学]