目的比较度洛西汀与文拉法辛治疗老年首发抑郁症伴疼痛的临床疗效和不良反应。方法将80例符合ICD-10中度抑郁发作诊断标准并伴躯体疼痛的老年首发抑郁症患者按随机数字表法分为度洛西汀组和文拉法辛组，分别给予度洛西汀与文拉法辛治疗，疗程8周。采用17项汉密尔顿抑郁量表（HAMD）、视觉模拟评分量表（VAS）评定疗效，采用不良反应量表（TESS）及实验室检查评定不良反应。结果度洛西汀组总有效率为72.5%，文拉法辛组总有效率为73.7%，差异无统计学意义（P＞0.05）。度洛西汀组治疗第1周末HAMD、VAS分值低于文拉法辛组，差异有统计学意义（P＜0.05）。两组患者不良反应发生率的差异无统计学意义（P＞0.05），但度洛西汀组心血管不良事件发生率低于文拉法辛组（P＜0.05）。结论度洛西汀和文拉法辛缓释剂治疗老年首发抑郁症伴疼痛的患者均有效，度洛西汀组心血管相关不良事件发生率较少，对老年患者安全有效，耐受性好。% Objective To evaluate the efficacy and adverse reactions of duloxetine versus venlafaxine in treatment of el-derly depressive patients with pain. Methods Eighty elderly patients, who met the ICD-10 diagnostic criteria for moderate de-pressive episode and was accompanied by physical pain, were randomly assigned to receive duloxetine or venlafaxine for a 8-week treatment. The efficacy was evaluated with Hamilton Depression Rating Scale 17 (HAMD17) and visual simulation Scale (VAS);the adverse reactions were evaluated with side effects assessment scale (TESS) and laboratory tests. Results The overal effective rate for duloxetine and venlafaxine was 72.5%and 73.7%respectively (P>0.05). The HAMD and VAS scores at the end of 1st week of duloxetine group was better than that of venlafaxine group (P<0.05). There was no significant difference in inci-dence of adverse reactions between two groups (P>0.05);but the incidence of cardiovascular events in duloxetine group was lower than that in venlafaxine group (P<0.05). Conclusion Duloxetine and venlafaxine extended release treatment are effective for elderly depressive patients with pain, duloxetine is safer and wel tolerated with less cardiovascular-related adverse events.
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