度洛西汀联合小剂量舒必利治疗躯体化障碍随机对照研究  

A randomized controlled study on the therapeutic effects and safety of duloxetine combined with small dose of sulpiril in treatment of somatization disorders

作　　者：李杰[1] 赵金香 魏丽宁[1] 王玉红[1] 王茜[1] 徐冬梅[1] 李占敏[1] 谢宝钦[1] 王新福[1] LI Jie;ZHAO Jinxiang;WEI Lining(Rongjun Hospital of Hebei Province,Hebei,Baoding 071000,China)

机构地区：[1]河北省荣军医院,河北省保定市071000

出　　处：《河北医药》2020年第23期3560-3563,共4页Hebei Medical Journal

摘　　要：目的探讨度洛西汀联合小剂量舒必利治疗躯体化障碍的疗效及安全性。方法将86例躯体化障碍患者随机分为2组,研究组(完成42例,脱落2例)给予度洛西汀联合小剂量舒必利,对照组(完成40例,脱落2例)单用度洛西汀治疗。用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表-17(HAMD-17)、90项症状清单(SCL-90)及治疗时出现的症状量表(TESS)评定疗效与不良反应,疗程8周。结果研究组HAMA总分、躯体性焦虑因子评分在治疗第1周末显著下降(P<0.05),对照组在第2周末显著下降(P<0.05);2组患者HAMA总分、躯体性焦虑因子评分在2、4、8周末持续下降(P<0.01),且研究组评分下降幅度>对照组(P<0.01)。研究组临床总有效率88.1%,高于对照组(P<0.05),2组痊愈率差异无统计学意义(P>0.05)。2组患者SCL-90的躯体化、强迫症状、人际关系、抑郁和焦虑等各因子治疗后评分均较治疗前显著下降,差异有统计学意义(P<0.01),治疗后研究组躯体化和人际关系评分低于对照组(P<0.05)。治疗第2、4、8周末,研究组HAMD评分低于对照组,差异无统计学意义(P>0.05)。研究组2组不良反应发生率35.7%,对照组37.5%,差异无统计学意义(P>0.05);研究组胃肠道反应发生率7.1%,对照组22.5%,2组比较,差异有统计学意义(P<0.05)。结论度洛西汀联合小剂量舒必利躯体化障碍提高了有效率,起效快,胃肠道反应少,值得作为临床治疗的备选方案。Objective To investigate the therapeutic effects and safety of duloxetine combined with small dose of sulpiril in treatment of somatization disorders.Methods A total of 86 patients with somatization disorders were randomly divided into research group(n=44)and control group(n=42).The patients in research group(42 cases completed,2 cases lost)were treated by duloxetine combined with low dose of sulpiril,however,the patients in control group(40 cases completed,2 cases lost)were treated by duloxetine only,with a treatment course of 8 weeks for both groups.The therapeutic effects and adverse reactions were assessed by Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-17(HAMD-17),Symptom Check List 90(SCL-90)and Treatment Emergent Symptom Scale(TESS).Results After 1-week treatment,the HAMA scores and somatic anxiety factor scores in research group were decreased significantly(P<0.05),which in control group were significantly decreased after 2-week treatment(P<0.05).The HAMA total scores and somatic anxiety factor scores in both groups were continously decreased at the end of 2w,4w and 8w(P<0.01),moreover the decrease degree in research group was more significant than that in control group(P<0.01).The total effective rate in research group was significantly higher than that in control group(P<0.05),however,there was no significant difference in healing rate between the two groups(P>0.05).The scores of somatization,obsessive-compulsive symptoms,interpersonal relationship,depression and anxiety of SCL-90 in both groups were decreased significantly after treatment(P<0.01),moreover,the scores of somatization and interpersonal relationship in research group were significantly lower than those in control group(P<0.05).At the end of 2w,4w and 8w after treatment,the HAMD scores in research group were significantly lower than those in control group(P>0.05).In addition the incidence rate of adverse reactions in research group was 35.7%,which in control group was 37.5%,there was no significant difference between the two group

关 键 词：躯体化障碍 度洛西汀 舒必利 随机对照研究 

分 类 号：R749[医药卫生—神经病学与精神病学]