2018 年第 11 期 第 13 卷

帕罗西汀联合阿立哌唑对老年躯体化障碍患者血清神经递质含量及交感神经皮肤反应的影响

Effect of paroxetine combined with aripiprazole on serum neurotransmitter content and sympathetic skin response in elderly patients with somatization disorder

作者：张恩旭张芳孙亮

英文作者：

单位：114047辽宁省鞍山市精神卫生中心康复三科

英文单位：

关键词：躯体化障碍；帕罗西汀；阿立哌唑；神经递质；交感神经皮肤反应

英文关键词：

• 摘要：

• 【摘要】目的    探讨帕罗西汀联合阿立哌唑对老年躯体化障碍患者血清神经递质含量及交感神经皮肤反应的影响。方法    选取2016年7月至2017年6月辽宁省鞍山市精神卫生中心收治的老年躯体化障碍患者112例为研究对象，采用随机数字表法分为观察组和对照组，各56例。对照组患者口服帕罗西汀治疗，观察组患者口服帕罗西汀联合阿立哌唑治疗。治疗8周后，比较2组临床疗效、血清神经递质含量、交感神经皮肤反应指标以及不良反应发生情况。结果    观察组总有效率明显高于对照组［89.3%(50/56)比73.2%(41/56)］（P＝0.018）。治疗8周后，2组血清多巴胺、5-羟吲哚乙酸、去甲肾上腺素含量均明显高于治疗前，观察组血清多巴胺、5-羟吲哚乙酸、去甲肾上腺素含量明显高于对照组［（73±9）ng/L比（56±7）ng/L、（2 355±423）ng/L比（1 935±336）ng/L、（41±5）ng/L比（35±5）ng/L］；2组上、下肢交感神经皮肤反应起始潜伏期均明显短于治疗前，上、下肢波幅明显大于治疗前；观察组上、下肢起始潜伏期明显短于对照组［（1.32±0.25）s比（1.51±0.34）s、（1.68±0.32）s比（1.84±0.41）s］，上、下肢波幅明显大于对照组［（2.12±0.35）mV比（1.72±0.40）mV、（1.84±0.26）mV比（1.58±0.34）mV］，差异均有统计学意义（均P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＝0.074）。结论    帕罗西汀联合阿立哌唑治疗有助于提高老年躯体化障碍患者的临床疗效，可能与调节血清神经递质含量、交感神经皮肤反应等因素有关。

• 【Abstract】Objective    To analyze the effect of paroxetine combined with aripiprazole on serum neurotransmitter content and sympathetic skin response in elderly patients with somatization disorder. Methods    A total of 112 elderly patients with somatization disorder admitted to Mental Health Center of Anshan from July 2016 to June 2017 were randomly divided into observation group and control group, with 56 cases in each group. The control group took paroxetine; the observation group took paroxetine and aripiprazole. Clinical efficacy, serum neurotransmitter, sympathetic skin response and adverse reactions were analyzed 8 weeks after treatment. Results    The total effective rate in the observation group was significantly higher than that in the control group［89.3%(50/56) vs 73.2%(41/56)］（P＝0.018）. After treatment, serum contents of dopamine, 5-hydroxyindole acetic acid and norepinephrine increased in both groups; the levels in the observation group were significantly higher than those in the control group［（73±9）ng/L vs （56±7）ng/L, （2 355±423）ng/L vs （1 935±336）ng/L, （41±5）ng/L vs （35±5）ng/L］（all P＜0.05）. Upper and lower limbs′ sympathetic skin response latent periods shortened and amplitudes increased after treatment; latent periods and amplitudes in the observation group were significantly shorter/larger than those in the control group［（1.32±0.25）s vs （1.51±0.34）s, （1.68±0.32）s vs （1.84±0.41）s; （2.12±0.35）mV vs （1.72±0.40）mV, （1.84±0.26）mV vs （1.58±0.34）mV］（all P＜0.05）. Incidence of adverse reactions was similar between the two groups（P＝0.074）. Conclusion    Paroxetine combined with aripiprazole has a good therapeutic effect on somatization disorder in elderly patients; the clinical efficacy may be related to the regulation on serum neurotransmitter and sympathetic skin response.