朱永 刘颖

[摘要] 目的 探討艾司西酞普兰和文拉法辛治疗老年焦虑症的疗效及安全性。 方法 选择2018年1月至2019年12月在我院诊断治疗的老年焦虑症患者100例为研究对象，随机分为艾司西酞普兰组与文拉法辛组，每组各50例。艾司西酞普兰组给予草酸艾司西酞普兰片口服治疗，文拉法辛组给予文拉法辛缓释片治疗。比较两组治疗后HAMA评分，临床疗效以及不良反应情况。 结果 （1）两组治疗后HAMA评分较治疗前均呈显著下降趋势，差异有统计学意义（P<0.05）;治疗后1周、2周艾司西酞普兰组HAMA评分显著低于文拉法辛组，差异有统计学意义（P<0.05）;治疗4周，两组HAMA评分比较，差异无统计学意义（P>0.05）。（2）两组临床疗效比较，差异无统计学意义（P>0.05）。（3）两组均未出现严重不良反应情况，均顺利完成疗程。艾司西酞普兰组不良反应总发生率显著低于文拉法辛组，差异有统计学意义（P<0.05）。结论 与文拉法辛相比，艾司西酞普兰治疗老年焦虑症起效更快，且不良反应更少。

[关键词] 艾司西酞普兰;文拉法辛;焦虑症;HAMA

[中图分类号] R749.4          [文献标识码] A          [文章编号] 1673-9701（2021）07-0022-04

Comparison of the efficacy and safety between escitalopram and venlafaxine in the treatment of senile anxiety

ZHU Yong1   LIU Ying2

1.The Sixth Ward， Jiamusi Psychiatric Welfare Home in Heilongjiang Province， Jiamusi   154002， China; 2.Inpatient Department Pharmacy， Jiamusi Psychiatric Hospital in Heilongjiang Province， Jiamusi   154002， China

[Abstract] Objective To explore the efficacy and safety between escitalopram and venlafaxine in the treatment of senile anxiety. Methods A total of 100 elderly patients with anxiety who were diagnosed and treated in the hospital from January 2018 to December 2019 were selected as the research objects， and they were randomly divided into escitalopram group and venlafaxine group with 50 cases in each group. The escitalopram group was given oral escitalopram oxalate tablets， and the venlafaxine group was given venlafaxine sustained-release tablets. The HAMA score， clinical efficacy and adverse reactions were compared between the two groups after treatment. Results （1）The HAMA scores of the two groups showed a significant downward trend after treatment， and the difference was statistically significant compared with that before treatment（P<0.05）. HAMA scores of the escitalopram group were significantly lower than those of the venlafaxine group at 1 and 2 weeks after treatment， and the difference was statistically significant（P<0.05）. After 4 weeks of treatment，there was no significant difference in the HAMA score between the two groups（P>0.05）. （2）There was no significant difference in clinical efficacy between the two groups （P>0.05）. （3）No serious adverse reactions occurred between the two groups， and the course of treatment was successfully completed. The total incidence of adverse reactions in the escitalopram group was significantly lower than that in the venlafaxine group， and the difference was statistically significant（P<0.05）. Conclusion Compared with venlafaxine，escitalopram is more effective in the treatment of senile anxiety and has fewer adverse reactions.

[Key words] Escitalopram; Venlafaxine; Anxiety; HAMA

焦虑症在神经症中最常见，主要表现为焦虑情绪，严重影响生活质量及身体健康。临床上老年焦虑症主要以躯体焦虑为主，患者为此而担心紧张、焦虑恐惧，影响身心健康[1]。艾司西酞普兰临床广泛应用于抗抑郁治疗，优点是不良反应较少，其通过增加突触间隙5-羟色胺水平来改善相关症状[2]。艾司西酞普兰可增加中枢神经系统5-羟色胺能的作用，抑制其再摄取，从而发挥作用。5-羟色胺转运蛋白上有两个结合位点，一般的药物只能与基本位点结合而发挥作用，而艾司西酞普兰除了能与基本位点结合外，还能与异构位点结合，因此起效速度更快。艾司西酞普兰应用于焦虑症的治疗，也具有较好的临床效果[3]。文拉……