目的 比較度洛西汀和氟哌噻噸美利曲辛片治療抑郁癥伴軀體疼痛障礙的臨床療效。方法 選取2013年6月-2016年12月在北京市石景山區(qū)五里坨醫(yī)院接受治療的抑郁癥伴軀體疼痛障礙患者128例，隨機分為對照組和治療組，每組各64例。脫落10例，實際完成118例，對照組58例，治療組60例。對照組患者口服氟哌噻噸美利曲辛片，起始劑量為1片/d，2周內(nèi)加至治療劑量4片/d。治療組在對照組的基礎上口服度洛西汀腸溶片，起始劑量為10 mg/d，2周內(nèi)加至治療劑量60mg/d。兩組患者均連續(xù)治療8周。觀察兩組的臨床療效，比較兩組的HAMD和HAMA評分、SF-MPQ評分和不良反應情況。結果 治療后，對照組和治療組的顯效率分別為17.24%、86.76%，有效率分別為87.93%、96.76%，兩組顯效率比較差異有統(tǒng)計學意義（P<0.01），兩組有效率比較差異無統(tǒng)計學意義。治療8周后，對照組的HAMD和HAMA評分均顯著降低，治療4、8周后，治療組HAMD和HAMA評分均顯著降低，治療前后比較差異具有統(tǒng)計學意義（P<0.01）；且治療組的上述評分顯著低于同期對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組的情感PRI評分和總PRI評分均顯著降低，且治療組的感覺PRI評分、VAS評分和PPI評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.01）；且治療后治療組的SF-MPQ評分低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。兩組均未出現(xiàn)嚴重藥物不良反應。結論 與氟哌噻噸美利曲辛片相比，度洛西汀治療抑郁癥伴軀體疼痛起效快，藥效更好，藥物安全性高。

Objective To compare the clinical effect between duloxetine and Flupentixol and Melitracen Tablets in treatment of depression associated with body pain disorders. Methods Patients (128 cases) with depression associated with body pain disorders in Wulituo Hospital of Shijingshan District in Beijing from June 2013 to December 2016 were divided into control (64 cases) and treatment (64 cases) groups. Ten cases of them were excluded, and patients (128 cases) with control (58 cases) and treatment (60 cases) groups were involved in the study. Patients in the control group were po administered with Flupentixol and Melitracen Tablets. The initial dose was 1 tablet/d, and was increased to 4 tablets/d in 2 weeks. Patients in the treatment group were po administered with Duloxetine Hydrochloride Enteric Tablets on the basis of the control group, the initial dose was 10 mg/d, and was increased to 60 mg/d in 2 weeks. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and HAMD and HAMA scores, SF-MPQ scores, and adverse reactions were compared. Results After treatment, the significant efficiencies in the control and treatment groups were 17.24% and 86.76%, respectively, and there was difference between two groups (P < 0.01). The clinical efficacies were 87.93% and 96.76%, respectively, withiout significant difference. After treatment for 8 weeks, HAMD and HAMA scores in the control group were significantly decreased, after treatment for 4 and 8 weeks, HAMD and HAMA scores in the treatment group were significantly decreased, and the difference was statistically significant in the same group (P < 0.01). These scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, emotion PRI scores and total scores in two groups were significantly decreased, feeling PRI scores, VAS scores, and PPI scores in the treatment group were significantly decreased, and there was difference between two groups (P < 0.01). These SF-MPQ scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). There were no serious adverse reactions in two groups. Compared with Flupentixol and Melitracen Tablets, duloxetine has better clinical effect in treatment of depression associated with body pain disorders, and has rapid effect with high safety.