氟伏沙明和其他SSRIs类抗抑郁药物治疗伴焦虑痛苦特征抑郁症患者的临床效应差异  

Clinical efficacy differences of fluvoxamine and other SSRIs in treating patients with depression accompanied by anxiety and painful features

作　　者：师云霖 殷军波[2] SHI Yunlin;YIN Junbo(Qingdao Medical College of Qingdao University,Qingdao 266000,China;Qingdao Mental Health Center Psychiatric Department)

机构地区：[1]青岛大学青岛医学院,山东青岛266000 [2]青岛市精神卫生中心精神科

出　　处：《山东第二医科大学学报》2025年第1期6-11,F0004,共7页Journal of Shandong Second Medical University

基　　金：青岛市医药卫生科研计划项目(项目编号:2021-WJZD149)。

摘　　要：目的 探讨氟伏沙明及其他抗抑郁药治疗伴焦虑痛苦特征抑郁症患者的临床疗效、不良反应和差异。方法 招募青岛市精神卫生中心收治的伴焦虑痛苦特征抑郁症患者120例,随机分为氟伏沙明组、帕罗西汀组、舍曲林组和艾司西酞普兰组,每组各30例,疗程均为6周。治疗前、治疗2周末、治疗4周末、治疗6周末分别采用HAMD-17以及HAMA评估患者的抑郁、焦虑症状。采用重复测量方差分析和简单效应分析比较4组临床症状变化的差异。采用χ2检验比较4组有效率、缓解率以及不良反应率等。结果 HAMD-17、HAMA评分组别主效应(F=0.333)无统计学意义,不同治疗时间主效应(F=217.816)均有统计学意义(均P<0.05),HAMD-17评分时间与分组存在交互效应(F=3.484,均P<0.05)。简单效应分析显示治疗前、治疗2周末、治疗4周末时4组HAMD-17评分差异无统计学意义,但在治疗6周末时,氟伏沙明组HAMD-17评分低于舍曲林组,差异有统计学意义(P<0.05)。4组治疗4周末、6周末缓解比例差异均无统计学意义(P>0.05);4组在治疗4周末、6周末有效比例差异有统计学意义(P<0.05)。4组患者嗜睡、头晕、头痛、失眠、焦虑、胃部不适、便秘不良反应比较,差异无统计学意义(均P>0.05)。治疗期间无死亡发生,无神经系统并发症和其他严重不良反应,未出现躁狂或轻躁狂。结论 氟伏沙明、帕罗西汀、舍曲林、艾司西酞普兰4种抗抑郁药治疗抑郁症伴焦虑痛苦特征患者疗效均显著且起效迅速,相比舍曲林,氟伏沙明在治疗后期显示出较好的效果,且4种抗抑郁药安全性均较好,后期仍需大样本量的临床研究进行验证。Objective To explore the clinical efficacy,adverse reactions,and differences of fluvoxamine and other antidepressants in the treatment of patients with depression accompanied by anxious misery.Methods A total of 120 patients with depression accompanied by anxious misery treated in Qingdao Mental Health Center were recruited and were randomly divided into four groups:fluvoxamine group,paroxetine group,sertraline group,and escitalopram group,with 30 cases in each group.The treatment course was 6 weeks for all.HAMD-17 and HAMA were used to assess the pa-tients'depression and anxiety symptoms respectively before treatment,at the end of week 2,week 4,and week 6 of treat-ment.Repeated measures ANOVA and simple effect analysis were used to compare the differences in clinical symptoms among four groups.Chi-square test was used to compare the efficacy rate,remission rate,and adverse reaction rate among four groups.Results The main effect between groups(F=0.333)was not statistically significant for HAMD-17 and HAMA scores,while the main effect of different treatment times(F=217.816)was statistically significant(all P<0.05).There was an interaction effect between time and groups for HAMD-17 scores(F=3.484,all P<0.05).Simple effect analysis showed no statistically significant differences in HAMD-17 scores among four groups at the beginning of treatment,at the end of week 2 and week 4.However,at the end of week 6,the HAMD-17 score in the fluvoxamine group was lower than that in the sertraline group with a statistically significant difference(P<0.05).There were no statistically significant differences in remission rates among four groups at the end of week 4 and week 6(P>0.05).There were sta-tistically significant differences in effective rates among four groups at the end of week 4 and week 6(P<0.05).There was no statistically significant difference in adverse reactions such as somnolence,dizziness,headache,insomnia,anxiety,gastrointestinal discomfort,and constipation among four groups(all P>0.05).No deaths occurred during th

关 键 词：抑郁症 焦虑 氟伏沙明 抑郁症伴焦虑痛苦特征 

分 类 号：R747.4[医药卫生—神经病学与精神病学]