目的：探讨米氮平、舍曲林、度洛西汀治疗伴躯体疼痛症状的抑郁症患者的临床疗效。方法102例伴躯体疼痛症状的抑郁症患者，随机分为米氮平治疗组、舍曲林治疗组、度洛西汀治疗组，各34例，分别给予米氮平、舍曲林、度洛西汀口服治疗8周。治疗前及治疗后1、2、4、8周末利用疼痛量表(MOSPM)、汉密尔顿抑郁量表(HAMD)评定疗效。结果三组治疗后 MOSPM 评分均低于治疗前(P<0.05)；治疗后1周末，米氮平治疗组、度洛西汀治疗组 MOSPM 评分[(66.21±13.42)、(65.48±13.71)分]低于舍曲林治疗组(P<0.05)；治疗后2、4、8周末度洛西汀治疗组、舍曲林治疗组 MOSPM 评分低于米氮平治疗组(P<0.05)。米氮平治疗组、度洛西汀治疗组治疗后 HAMD 评分均低于治疗前(P<0.05)，治疗后1、8周末米氮平治疗组、度洛西汀治疗组 HAMD 评分低于舍曲林治疗组(P<0.05)。结论度洛西汀在改善伴躯体疼痛症状的抑郁症患者抑郁症状及躯体疼痛症状方面，效果优于米氮平和舍曲林，起效迅速，值得在临床上推广应用。%Objective To investigate clinical effect by mirtazapine, sertraline, and duloxetine in the treatment of depression patients with complicated somatic pain symptoms. Methods A total of 102 depression patients with complicated somatic pain symptoms were randomly divided into mirtazapine treatment group, sertraline treatment group, and duloxetine treatment group, with 34 cases in each group. They received respectively treatment by mirtazapine, sertraline, and duloxetine for 8 weeks. Medical outcomes study pain measures (MOSPM) and Hamilton depression scale (HAMD) were applied in curative effect evaluation before and after 1, 2, 4, 8 weeks of treatment. Results All three groups had lower MOSPM scores after treatment than those before treatment (P<0.05). After 1 week of treatment, mirtazapine treatment group and duloxetine treatment group had lower MOSPM scores[(66.21±13.42), (65.48±13.71) points]than sertraline treatment group (P<0.05). After 2, 4, 8 weeks of treatment, duloxetine treatment group and sertraline treatment group had lower MOSPM scores than mirtazapine treatment group (P<0.05). Mirtazapine treatment group and duloxetine treatment group had all lower HAMD scores after treatment than those before treatment (P<0.05). After 1 and 8 weeks of treatment, mirtazapine treatment group and duloxetine treatment group had lower HAMD scores than sertraline treatment group (P<0.05). Conclusion Duloxetine shows better effect than mirtazapine and sertraline in improving depression and somatic pain symptoms in depression patients with complicated somatic pain symptoms. It provides quick onset effect, and it is worth clinical promotion and application.
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