目的:观察帕罗西汀治疗非便秘型肠易激综合征的临床疗效。方法:符合罗马Ⅲ诊断标准的非便秘型肠易激综合征患者107例,随机分为2组,治疗组57例,给予帕罗西汀20 mg,每日晨起顿服,匹维溴铵50 mg,3次/d,口服;对照组50例,给予谷维素30 mg, 3次/d,口服,匹维溴铵50 mg,3次/d,口服,疗程4周。观察患者腹痛、腹泻、腹部不适、排便次数、大便性状,以及焦虑、抑郁等改善情况。结果:治疗组总有效率为930%,对照组总有效率为760%,两组比较差异有统计学意义(Plt;001)。结论:帕罗西汀治疗非便秘型肠易激综合征有明确的临床意义。
Objective To evaluate the effects of selective serotonin reuptake inhibitors ( SSRIs) on sleep apneas in Sprague-Dawley ( SD) rats. Methods Thirty adultmale SD rats were randomly divided into two groups ( 15 rats in each group) . The treatment group and the control group were injected intraperitoneally with paroxetine ( 10 mg· kg- 1 · d - 1 ) and sterile distilled water ( 2 mL· kg- 1 · d - 1) for 7 days respectively. Parameters about sleep apnea and sleep structure were measured before and after the treatment. Results In the treatment group, there was a significant reduction of apnea index ( AI) from ( 12. 4 ±3. 7)times /hour to ( 7. 4 ±2. 2) times/ hour ( P = 0. 000) . Both post sigh apnea index ( PSAI) and spontaneous apnea index ( SPAI) were decreased significantly ( P = 0. 000 and 0. 021 respectively) in non-rapid eye movement ( NREM) sleep, but not in REM sleep. REM sleep was reduced from 8. 6% to 8. 0% ( P =0. 013) and its latency was increased from ( 54. 1 ±48. 4) min to ( 110. 9 ±43. 4) min ( P = 0. 001) in the treatment group, as well as the sleep-onset latency [ from ( 20. 7 ±9. 1) min to ( 30. 0 ±15. 7) min, P =0. 038] . Conclusion Paroxetine can reduce sleep apneas in SD rats during NREMsleep. Its effects on sleep structure include reducing REM time, increasing REM latency and sleep-onset latency.
Objective To systematically evaluate the efficacy and safety of duloxetine versus paroxetine for adults’ depression. Methods A search was conducted in The Cochrane Library (Issue 6, 2011), Pubmed (1998 to June 2011), CNKI (1998 to June 2011), VIP (1998 to June 2011), CBM (1998 to June 2011), Wanfang database (1998 to June 2011), MEDLINE (1996 to June 2011) and Science Direct (1998 to June 2011). The randomized controlled trials (RCTs) on duloxetine versus paroxetine for adults’ depression were collected. The quality of the included trials was assessed according to the Cochrane Handbook 5.0, and the systematic analysis was conducted by using RevMan 5.0 software. Results Six RCTs involving 1 106 patients were included. The results of meta-analysis showed that: a) After eight-week treatment, there were no significant differences in the effective rate (RR=0.96, 95%CI 0.89 to 1.05, P=0.39) and the final cure rate (RR=0.99, 95%CI 0.86 to 1.15, P=0.93) between the duloxetine and paroxetine groups; b) Adverse reaction: The incidence rate of somnolence in the duloxetine group was lower than that of the paroxetine group (RR=0.63, 95%CI 0.41 to 0.96, P=0.03), oppositely, the incidence rate of abnormal ECG was higher in the duloxetine group (RR=1.91, 95%CI, 1.02 to 3.58, P=0.04). And the other common adverse reactions were not significantly different between the two groups (Pgt;0.05). Conclusion After eight-week treatment, there are no significant differences in the effective rate and the final cure rate between duloxetine and paroxetine. Duloxetine tends easily to induce the abnormal ECG compared with paroxetine.
Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.
ObjectiveTo explore the association between paroxetine (Seroxat) and level of blood sugar and endocrine hormones in pre-diabetes patients with anxiety and depression. MethodsFifty-four pre-diabetes patients with anxiety and depression diagnosed from January 2010 to December 2012 were recruited. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess depression and anxiety. All the patients were treated by paroxetine. The glucose tolerance test (OGTT), ACTH and cortisol were tested in patients at baseline and within 24 weeks. ResultsAfter 24 weeks' treatment, the level of anxiety and depression as well as the OGTT 0.5 h (0.5 h PG), OGTT 1 h (1 h PG), OGTT 2 h (2 h PG), glycated hemoglobin (HbA1c), adrenocorticotropic hormone (ACTH) and cortisol were significantly decreased (P<0.05 or P<0.01). The glycated HbA1c had a positive correlation with adrenocorticotropic hormone (ACTH) and cortisol (F). Before and after treatment, the reduced rate of ACTH and reduced rate of cortisol respectively exhibited a positive correlation with the reduced rate of HbA1c, reduced rate of SAS and reduced rate of SDS. ConclusionAnti-anxiety depression treatment can lower blood sugar level in pre-diabetes patients with anxiety and depression significantly, which may be related to the activity of HPA axis.