帕罗西汀和多虑平联合氯唑沙宗治疗伴有焦虑抑郁情绪的紧张型头痛的临床对照研究

摘要

目的：比较帕罗西汀和多虑平联合氯唑沙宗治疗伴有焦虑抑郁情绪的紧张型头痛的临床疗效及安全性。方法选择在我科门诊治疗伴有焦虑抑郁情绪的紧张型头痛患者56例为研究对象，采用随机数字表法分为帕罗西汀组和多虑平组，每组28例，帕罗西汀组在常规服用氯唑沙宗的基础上加服帕罗西汀治疗，多虑平组加服多虑平治疗，另外回顾以往常规应用氯唑沙宗治疗的伴有焦虑抑郁情绪的紧张型头痛患者30例的临床资料，并作为对照组。分别对治疗12周后三组患者头痛、焦虑抑郁情绪改善情况及药物不良反应发生情况进行评价，并进行对比分析。结果所有患者均顺利完成12周的治疗，治疗后帕罗西汀组显效率和总有效率均明显高于对照组，差异均有统计学意义(P<0．05或P<0．01)；帕罗西汀组患者总有效率略高于多虑平组，但差异无统计学意义(P>0．05)，而帕罗西汀组显效率明显高于多虑平组，差异有统计学意义(P<0．05)；多虑平组显效率与对照组相当，总有效率高于对照组，但差异无统计学意义( P>0．05)。帕罗西汀组和多虑平组患者HAMA评分和HAMD评分均较治疗前明显改善(P<0．01)，且改善程度明显优于对照组(P<0．05)；与多虑平组相比，帕罗西汀组HAMA和HAMD评分改善更为明显，差异均有统计学意义( P<0．05)。帕罗西汀组和对照组不良反应发生率和不良反应严重程度评分均明显低于多虑平组( P<0．05或P<0．01)；而帕罗西汀组和对照组间差异无统计学意义(P>0．05)。结论帕罗西汀联合氯唑沙宗治疗伴有焦虑抑郁的紧张型头痛的临床疗效满意，不良反应少，且较轻微，值得临床推广应用。%Objective To compare the clinical efficacy and safety of tension-type headache with anxiety de-pression treating with paroxetine and doxepin combined with chlorzoxazone. Methods To choose tension headache pa-tients with anxiety depression as the research object,using the random number table method,the patients were divided into paroxetine group and doxepin group,paroxetine group took chlorzoxazone treatment plus paroxetine on the basis of routine therapy,doxepin group plus doxepin therapy. The patients treating with chlorzoxazone as a control group,at 12 weeks after treatment,evaluated the condition of patients with headache,anxiety,depression mood and drug side effects of the three groups,and gave comparative analysis. Results All patients successfully completed 12 weeks treatment, after treatment,the total effective rate and significant efficiency of paroxetine group were obviously higher than that of control group ( P <0. 05 or P <0. 01 );the total effective rate of paroxetine group was slightly higher than that of doxepin group,but there was no significant difference (P >0. 05),but the significant efficiency of paroxetine group was obviously higher than that of doxepin group,the difference was significant (P<0. 05);the significant efficiency of doxepin group and control group had no significant difference,the total effective rate was slightly higher than that of control group,but there was no significant difference between the two groups (P>0. 05). HAMA and HAMD scores of paroxetine group and doxepin group obviously improved than that of prior treatment (P<0. 01),and the improved de-gree was better than the control group (P<0. 05);Compared with doxepin group,HAMA and HAMD scores improve-ment of paroxetine group was more apparent,the difference was significant (P<0. 05). The incidence of adverse e-vents of paroxetine group and control group were obviously lower than that of doxepin group (P<0. 05 or P<0. 01), and the difference of paroxetine group and control group had no significant difference ( P>0. 05 ) . Conclusion The clinical efficacy of tension-type headache with anxiety depression treating with paroxetine combined chlorzoxazone is obvious,the adverse events are less and slight,and shows good security,it is worth of popularization and application.