CAJ | 학술논문

目的：比较文拉法辛与帕罗西汀治疗广泛性焦虑的疗效、功能改善及安全性。方法将68例广泛性焦虑患者随机分为2组，观察组服用文拉法辛，对照组服用帕罗西汀片，疗程6周。于治疗前及治疗后第1、2、4、6周末进行汉密尔顿焦虑量表（ HAMA）、功能大体评定量表（ GAF）及副反应量表（ TESS）评定。结果两组患者HAMA总分、精神焦虑评分、躯体焦虑评分均呈下降趋势，观察组治疗第1周后的总分、精神焦虑因子分及治疗第2周后的躯体焦虑因子分各时点与治疗前比较差异均有统计学意义（P＜0.05），对照组治疗第2周后的总分、精神焦虑因子分及治疗第4周后的躯体焦虑因子分各时点与治疗前比较差异均有统计学意义（P＜0.05），但两组间主效应比较差异无统计学意义（P＞0.05），观察组下降幅度较对照组下降幅度大，差异具有统计学意义（ P＜0.05）。两组患者GAF评分均呈不断升高趋势，治疗1周后各时点与治疗前比较差异均有统计学意义（P＜0.05），但两组间主效应比较差异无统计学意义（P＞0.05），两组间上升幅度比较差异无统计学意义（P＞0.05）；两组合并使用苯二氮卓类药物率差异无统计学意义（P＞0.05）；两组不良反应差异无统计学意义（ P＞0.05）。结论文拉法辛与帕罗西汀治疗广泛性焦虑安全、有效，能够较好改善社会功能，文拉法辛起效较快，改善躯体症状较好。
목적：비교문랍법신여파라서정치료엄범성초필적료효、공능개선급안전성。방법장68례엄범성초필환자수궤분위2조，관찰조복용문랍법신，대조조복용파라서정편，료정6주。우치료전급치료후제1、2、4、6주말진행한밀이돈초필량표（ HAMA）、공능대체평정량표（ GAF）급부반응량표（ TESS）평정。결과량조환자HAMA총분、정신초필평분、구체초필평분균정하강추세，관찰조치료제1주후적총분、정신초필인자분급치료제2주후적구체초필인자분각시점여치료전비교차이균유통계학의의（P＜0.05），대조조치료제2주후적총분、정신초필인자분급치료제4주후적구체초필인자분각시점여치료전비교차이균유통계학의의（P＜0.05），단량조간주효응비교차이무통계학의의（P＞0.05），관찰조하강폭도교대조조하강폭도대，차이구유통계학의의（ P＜0.05）。량조환자GAF평분균정불단승고추세，치료1주후각시점여치료전비교차이균유통계학의의（P＜0.05），단량조간주효응비교차이무통계학의의（P＞0.05），량조간상승폭도비교차이무통계학의의（P＞0.05）；량조합병사용분이담탁류약물솔차이무통계학의의（P＞0.05）；량조불량반응차이무통계학의의（ P＞0.05）。결논문랍법신여파라서정치료엄범성초필안전、유효，능구교호개선사회공능，문랍법신기효교쾌，개선구체증상교호。
Objective To compare the effect , social function and safety of venlafaxine versus paroxetine in the treatment of general anxiety disorder .Methods Sixty-eight patients with generalized anxiety disorder were ran-domly divided into two groups .The observation group was given venlafaxine , the control group was given paroxetine for 6 weeks.The Hamilton Anxiety Scale(HAMA),global assessment function(GAF) and side effects scale(TESS) were used to assess the therapeutic effects before treatment and at the end of the 1st,2nd,4th,6th week after treat-ment, respectively.Results There was declined trend in HAMA′s total scores, mental anxiety scores and somatic anxiety scores in two groups .The MAMA′s total scores, mental anxiety scores at every time points after 1st week′s treatment and the HAMA′s somatic anxiety somatic anxiety scores at every time points after 2nd week′s treatment were significantly decreased in the observation group compared with those before treatment ( P<0.05 ) .The HAMA′s total scores, mental anxiety scores at every time points after 2nd week′s treatment, the HAMA′s somatic anxiety scores at every time points after 4th week′s treatment were significantly decreased in the control group compared with those be-fore treatment ( P<0.05 ) .There was no statistically difference in the main effect of HAMA′s scores between two groups(P >0.05).The declined amplitude in HAMA scores in the observation group was significantly greater than that in the control group ( P<0.05 ) .There was an ascended trend in GAF′s scores in two groups .The GAF′s scores at every time points after 1st week′s treatment were significantly increased compared with those before treatment (P<0.05 ) ,but there were no statistically difference in the main effect of GAF′s scores and the ascended amplitude in GAF′s scores between two groups ( P>0.05 ) .There were no statistically difference in the rate of adverse reaction and the use of diazepams ( P>0.05 ) .Conclusion Using venlafaxine and paroxetine for treating generalized anxiety dis-order are effective and safe , but venlafaxine acts more rapidly and more improves the somatic symptoms compared with paroxetine .