文拉法辛与帕罗西汀治疗伴慢性疼痛抑郁症对照研究

摘要

Objective To explore the efficacy and safety of venlafaxine vs. paroxetine in the treatment of depression concomitant with chronic pain. Methods A total of 56 depressive patients concomitant with chronic pain were randomly divided into venlafaxine group (28 cases) and paroxetine group (28 cases) treated with venlafaxine and paroxetine respectively for 8 weeks. The efficacy was evaluated with Hamilton Depression scale (HAMD) and Visual Analogue Scale ( VAS) , and the safety was evaluated with Treatment Emergent Symptom Scale (TESS). Results At the end of 8-week treatment, there were significant differences in clinical cure rate (75. 0% vs. 53. 6% ) and effective power (89.3% vs. 64.3% ) between venlafaxine group and paroxetine group (P<0.05). Scores of HAMD and VAS in the two groups decreased significantly at the end of the 8-weeks treatment compared with baseline ( P <0.05 ). The reducing rate of HAMD in venlafaxine group were significantly higher than that in paroxetine group at the 1st, 2nd, 4th, 8th weekend of the treatment ( P <0.05 ). The reducing rate of VAS in venlafaxine group were significantly higher than that in paroxetine group at the 2nd, 4th, 8th weekend of the treatment (P < 0. 05). The two groups had similar adverse effects and good tolerance. Conclusion Compared with paroxetine, venlafaxine has better efficacy and takes effect more quickly in the treatment of depression concomitant with chronic pain.%目的 比较文拉法辛与帕罗西汀治疗伴有慢性疼痛抑郁症的疗效及安全性.方法 将56例伴有慢性疼痛的抑郁症患者随机分成两组各28例,分别给予文拉法辛和帕罗西汀治疗8周,并应用汉密尔顿抑郁量表(HAMD)、视觉模拟评分法(VAS)和不良反应量表(TESS)评定疗效和不良反应.结果 治疗8周末文拉法辛组临床痊愈率为75.0％,有效率为89.3％.帕罗西汀组临床痊愈率为53.6％,有效率为64.3％,两组比较差异有显著性((P＜0.05).治疗8周末文拉法辛组与帕罗西汀组HAMD与VAS评分均显著下降((P＜0.05).治疗第1、2、4、8周末文拉法辛组HAMD减分率均高于帕罗西汀组,两组比较差异有显著性((P＜0.05).治疗第2、4、8周末文拉法辛组VAS减分率均高于帕罗西汀组,两组比较差异有显著性((P＜0.05).两组不良反应相似,均有较好耐受性.结论 文拉法辛治疗伴有慢性疼痛的抑郁症较帕罗西汀组起效更快,抗抑郁及改善疼痛症状效果更强,耐受性好.