枸櫞酸坦度螺酮和鹽酸丁螺環(huán)酮治療第二代抗抑郁藥所致性功能障礙的對照研究

顧成宇 邢葆平 張瀅 魏紅輝 孫寧寧

枸櫞酸坦度螺酮和鹽酸丁螺環(huán)酮治療第二代抗抑郁藥所致性功能障礙的對照研究

顧成宇 邢葆平 張瀅 魏紅輝 孫寧寧

目的 比較枸櫞酸坦度螺酮和鹽酸丁螺環(huán)酮治療第二代抗抑郁藥所致性功能障礙中的療效和安全性。方法 選取56 例符合 DSM-IV-TR 藥物所致性功能障礙診斷標(biāo)準(zhǔn)的患者，按照隨機數(shù)字表法分為枸櫞酸坦度螺酮研究組（研究組）和鹽酸丁螺環(huán)酮標(biāo)準(zhǔn)對照組（對照組），每組 28 例。兩組患者分別接受 6 周枸櫞酸坦度螺酮（40mg/d）或鹽酸丁螺環(huán)酮（40mg/d）治療。基線時和治療第 2、4、6 周采用亞利桑那性體驗量表（ASEX）和不良反應(yīng)量表（TESS）評定療效和不良反應(yīng)。 結(jié)果 兩組患者 ASEX 總分在治療第2、4、6 周和基線相比均明顯降低（均 P＜0.05），但兩組間比較均無統(tǒng)計學(xué)差異（均 P ＞0.05）。兩組 TESS 總分在第 2 周均較基線明顯增高（均 P＜0.05）；對照組 TESS 總分在第 2 周高于研究組，且有統(tǒng)計學(xué)差異（P＜0.05）。兩組 TESS 總分在基線、治療第 4、6 周均無統(tǒng)計學(xué)差異（均 P ＞0.05）。 結(jié)論 枸櫞酸坦度螺酮和鹽酸丁螺環(huán)酮均能有效治療抗抑郁藥所致性功能障礙，且不良反應(yīng)均較少，有較好的臨床應(yīng)用價值。

枸櫞酸坦度螺酮 鹽酸丁螺環(huán)酮 抗抑郁藥 性功能障礙

【 Abstract 】 Objective To compare the efficacy and safety between Tandospirone and Buspirone in treatment of sexual dysfunction associated with antidepressants. Methods Fifty six patients,who received new generation antidepressant therapy for at least 8 weeks,and developed sexual dysfunction met the criteria of DSM-IV-TR,were enrolled in the study.Patients were randomly assigned to a 6-week trial with tandospirone(study group,n=28,40mg/d)or buspirone(control group,n=28,40mg/d). Outcomes were evaluated by using Arizona Sexual Experience Scale(ASEX)for efficacy and Treatment Emergent Symptom Scale (TESS)for adverse effects at the baseline,and the end of wk2,wk4 and wk6. Results Compared to baseline,patients in both groups presented significantly improvement in sexual function at the end of wk2,wk4 and wk6(P＜0.05).There were no significant in the total scores of the ASEXbetween the two groups after treatment.At wk2 the TESS score in both groups was higher than that of baseline(P＜0.05),and TESS score in control group was higher than that in study group(P ＜0.05).However,there were no significant differences in TESS scores between baseline and those at wk4 and wk6 in both groups(P ＞0.05). Conclusion Tandospirone and buspirone are effective in treatment of antidepressant-associated sexual dysfunction with mild adverse effects.

【 Key words 】 Tandospirone Buspirone Anti-depressive agents Sexual dysfunction

抑郁癥是導(dǎo)致嚴(yán)重致殘的公共健康問題，年患病率高達 6.6%，終身患病率高達 16.2%[1]。長期服用抗抑郁藥維持治療是標(biāo)準(zhǔn)治療方案，目前第二代抗抑郁藥如選擇性 5 羥色胺再攝取抑制劑（SSRIS）、5 羥色胺和去甲腎上腺素再攝取抑制劑（SNRIS）已經(jīng)成為臨床上主要的抗抑郁藥物。但是第……