曲唑酮、坦度螺酮和阿普唑仑治疗广泛性焦虑症的疗效比较

目的比较曲唑酮、坦度螺酮和阿普唑仑对广泛性焦虑症的短、中期疗效和安全性及服药依从性的差异。方法223例广泛性焦虑症患者随机分入曲唑酮组(77例)、坦度螺酮组(74例)和阿普唑仑组(77例),分别给予相应的药物治疗6周,半年后随访。于治疗前、治疗后1,2,4,6周末和随访时应用汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)评定疗效和安全性;并于治疗前、治疗6周末和随访时检测血压、心电图、血常规。结果曲唑酮和阿普唑仑2组患者治疗第1周末HAMA总分与治疗前比较有显著下降(P<0.01),坦度螺酮组患者治疗第2周末HAMA总分显著下降(P<0.01)。随访时阿普唑仑组患者HAMA总分显著高于曲唑酮和坦度螺酮组(P<0.05)。曲唑酮、坦度螺酮和阿普唑仑3组的显效率分别为71.5%、67.6%和67.5%,经2检验均差异无显著性(P>0.05)。曲唑酮和坦度螺酮2组副反应的总发生率均显著低于阿普唑仑组(总2=7.68,P<0.05;分2=7.44,P<0.01),曲唑酮组性功能障碍的发生率显著低于坦度螺酮组(2=16.03,P<0.01),曲唑酮和阿普唑仑组患者嗜睡的发生率显著高于坦度螺酮组(总2=16.51,P<0.01;分2=11.94,P<0.01)。随访时曲唑酮和坦度螺酮组服药依从性好者显著高于阿普唑仑组(总2=19.43,P<0.01;分2=19.19,P<0.01)。结论曲唑酮和坦度螺酮治疗广泛性焦虑症的短期疗效与阿普唑仑相当,中期疗效和服药依从性优于阿普唑仑,副反应的发生率低。

Comparison to the efficacy of trazodone, tandospirone and alprazolam in treatment of patients with general anxiety

Objective To compare the efficacy and safety of trazodone,tandospirone and alprazolam in the treatment of patients with general anxiety.Methods 223 patients with general anxiety were divided into trazodone group(77 cases),tandospirone group(74 cases)and alprazolam group(77 cases)by randomly and were treated by corresponding drugs for 6 weeks and were followed up for half of year.The therapeutic response and safety were evaluated by scale of HAMA and TESS at before and end treatment.Results The HAMA score of trazodone and alprazolam groups begin significantly fall from treatment first weekend,while the score of tandospirone group is marked descend from after treatment second weekend(P<0.01).In the course of following up,the HAMA score of alprazolam group is higher than that in trazodone and tandospirone groups(P<0.05).There were no difference in efficacy between three groups.The generate rate of side effect in Alprazolam group is significantly than other groups(_ total2=7.68,P<0.05,_ division2=7.44,P<0.01).But the generate rate sexual function disorder in trazodone group is distinctly lower than that in tandospirone(_2=16.03,P<0.01).In addition,compliance of trazodone and tandospirone groups are better than that in the alprazolam group(_ total2=19.43,P<0.01;_ division2=19.19,P<0.01).Conclusion The trazodone and tandospirone are better medicines in treatment to general anxiety.