度洛西汀对伴躯体疼痛症状的抑郁症患者血浆P物质水平的影响及其与疗效的关系

摘要

Objective To explore the influence of duloxetine on plasma level of substance P and its relationship with effectiveness of duloxetine in depressive patients with body pain symptoms. Methods 30 depressive patients with body pain symptoms ( study group) were treated with 60 mg/d duloxetine for 4 weeks. The plasma level of substance P, Visual Analogue Scale ( VAS) ,17-item Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) were measured at baseline and at the end of the treatment. Plasma level of substance P in study group was compared with that in thirty healthy volunteers (control group). Results Compared with control group, plasma level of substance P at baseline in study group was significantly higher ( P =0.000). It decreased significantly after the 4-week treatment ( P = 0.001) but remained higher than that in control group (P =0.028). Scores of VAS, HAMD-17 and HAMA in study group at the end of the treatment decreased significantly when compared with those at the baseline (P =0. 000). The reduction of substance P showed significantly positive correlations with reduction rate of VAS score and HAMD-17 score (r =0.457,0.401 respectively; P =0.011, 0.029 respectively). Conclusion Duloxetine can reduce plasma level of substance P in depressive patients with body pain symptoms, which may be involved in the pharmacological mechanism of relieving body pain symptoms in those patients.%目的 探讨伴躯体疼痛症状的抑郁症患者在度洛西汀治疗过程中,血浆P物质水平的变化与药物疗效间的关系.方法 30例伴躯体疼痛症状的抑郁症患者(患者组)接受度洛西汀治疗(60 mg/d),疗程4周.于治疗前、治疗后4周末测定血浆P物质水平,并与30例健康志愿者(对照组)进行对照；同时评定疼痛视觉模拟评分(VAS)、17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评分.结果 (1)患者组治疗前血浆P物质水平较对照组显著增高(P=0.000)；治疗4周末较治疗前显著降低(P=0.001),但仍高于对照组(P=0.028).(2)患者组治疗4周末VAS、HAMD-17、HAMA评分较治疗前均有显著下降(P =0.000).(3)治疗后血浆P物质的下降率与VAS减分率、HAMD-17减分率呈正相关(r=0.457、0.401,P=0.011,0.029).结论 度洛西汀可降低伴躯体疼痛症状的抑郁症患者血浆P物质水平,可能是度洛西汀治疗抑郁症患者躯体疼痛症状的药理作用机制之一.