四种SSRIs类药物治疗强迫症安全性和有效性的差异研究  

Study on the differences in safety and effectiveness of four SSRIs in the treatment of obsessive-compulsive disorder

作　　者：李双双 肖南海 黄金荣 Li Shuangshuang;Xiao Nanhai;Huang Jinrong(Ganzhou People’s Hospital,Ganzhou Hospital,Nanfang Hospital,Southern Medical University,Ganzhou,Jiangxi 341000,China;Yudu People’s Hospital,Ganzhou,Jiangxi 342300,China)

机构地区：[1]江西省赣州市人民医院,南方医科大学南方医院赣州医院,江西赣州341000 [2]江西省于都县人民医院,江西赣州342300

出　　处：《首都食品与医药》2025年第10期74-77,共4页Capital Food Medicine

基　　金：2022年度赣州市科技局指导性计划项目(编号:GZ2022ZSF069)。

摘　　要：目的探究草酸艾司西酞普兰、盐酸舍曲林、盐酸帕罗西汀和马来酸氟伏沙明这四种选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitors,SSRIs)类药物治疗强迫症(Obsessive-Compulsive Disorder,OCD)安全性和有效性的差异。方法选择2022年9月-2024年11月我院精神心理科收治的160例强迫症患者,随机分为四组,即艾司西酞普兰组、舍曲林组、帕罗西汀组和氟伏沙明组,每组各40例。比较四组强迫症状、情绪状态、临床疗效及不良反应情况的差异。结果四组治疗后耶鲁-布朗强迫症状量表(Yale-Brown scale for Obsessive-Compulsive Symptoms,Y-BOCS)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)和汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分均较治疗前显著降低(P<0.05);四组不良反应比较,差异无统计学意义(P>0.05)。治疗8周和12周后,舍曲林组Y-BOCS、HAMA和HAMD评分均显著低于其他三组(P<0.05);艾司西酞普兰组Y-BOCS评分也显著低于帕罗西汀组和氟伏沙明组(P<0.05);帕罗西汀组和氟伏沙明组Y-BOCS评分比较,无显著性差异(P>0.05);艾司西酞普兰组、帕罗西汀组和氟伏沙明组三组HAMA和HAMD评分的比较则无统计学差异(P>0.05)。舍曲林组的总有效率显著高于其他三组(P<0.05);艾司西酞普兰组的总有效率次之,显著高于帕罗西汀组和氟伏沙明组(P<0.05);帕罗西汀组和氟伏沙明组总有效率的比较则无统计学差异(P>0.05)。结论舍曲林是四种SSRIs类药物中治疗强迫症疗效最佳的药物,其次是艾司西酞普兰,但艾司西酞普兰在改善患者情绪状态方面与帕罗西汀、氟伏沙明相当,四种药物具有相等的安全性表现。Objective To investigate the differences in safety and effectiveness of four selective serotonin reuptake inhibitors(SSRIs),namely escitalopram oxalate,sertraline hydrochloride,paroxetine hydrochloride,and fluvoxamine maleate,in the treatment of obsessive-compulsive disorder(OCD).Methods A total of 160 patients with OCD admitted to the psychiatry department of our hospital from September 2022 to November 2024 were randomly divided into four groups:the escitalopram group,the sertraline group,the paroxetine group,and the fluvoxamine group,with 40 patients in each.Differences in obsessive-compulsive symptoms,emotional status,clinical efficacy,and adverse reactions were compared among the four groups.Results After treatment,the Y-BOCS,HAMA,and HAMD scores of all four groups were significantly lower than those before treatment(P<0.05).There was no statistically significant difference in adverse reactions among the groups(P>0.05).At 8 and 12 weeks after treatment,the Y-BOCS,HAMA,and HAMD scores of the sertraline group were significantly lower than those of the other three groups(P<0.05).The Y-BOCS score of the escitalopram group was also significantly lower than those of the paroxetine group and the fluvoxamine group(P<0.05).There was no significant difference in Y-BOCS scores between the paroxetine group and the fluvoxamine group(P>0.05).Additionally,there was no statistically significant difference in HAMA and HAMD scores among the escitalopram,paroxetine,and fluvoxamine groups(P>0.05).The overall effective rate of the sertraline group was significantly higher than that of the other three groups(P<0.05).The overall effective rate of the escitalopram group was the second highest and significantly higher than that of the paroxetine group and the fluvoxamine group(P<0.05).There was no statistically significant difference in the overall effective rate between the paroxetine group and the fluvoxamine group(P>0.05).Conclusion Sertraline is the most effective among the four SSRIs in the treatment of OCD,followed by escitalo

关 键 词：SSRIs类药物 强迫症 安全性 有效性 

分 类 号：R749.05[医药卫生—神经病学与精神病学]