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目的比较阿米替林基础治疗,加用米氮平,加用白芍总苷胶囊及联合用药4组对纤维肌痛综合征(FS)的疗效。方法分别测定记录4组治疗前,治疗1、3个月末时,疼痛程度目测标尺法(VAS)评分、90项症状自评量表(SCL—90)、Hamilton焦虑量表(HAMA)、Hamilton抑郁量表(HAMD)的变化比较。结果①B组1、3个月末SCL—90下降值明显低于A组(P<0.05);②C组1个月末VAS下降值明显低于B组(P<0.05);③D组1、3个月末的VAS/SCL—90下降值明显低于A、B、C组(P<0.05);④本研究中使用的HAMA、HAMD量表,观察中与临床症状、体征变化缺乏一致性。结论①在阿米替林等药物治疗FS基础上,联合小剂量米氮平及白芍总苷胶囊能明显提高疗效,且较安全。②SCL—90量表引入FS疗效评定,对FS症状的量化、活动度观察可能有益。③HAMA和HAMD量表不适用于FS诊断及疗效观察。
Objective To compare the efficacy of amitriptyline in basic treatment with mirtazapine and total glucosides of paeony plus four groups on fibromyalgia syndrome (FS). Methods The scores of visual analog scale (VAS), 90 symptom checklist (SCL-90), Hamilton Anxiety Scale (HAMA), Hamilton depression Scale (HAMD) changes in comparison. Results ① The decrease of SCL-90 in group B at the end of 1 and 3 months was significantly lower than that of group A (P <0.05); ② The decrease of VAS in group C at 1 month was significantly lower than that of group B (P <0.05); (P <0.05). (4) The HAMA and HAMD scales used in this study were not consistent with those observed in clinical symptoms and signs. Conclusion ① Amitriptyline and other drugs based on the treatment of FS, combined with low-dose mirtazapine and total glucosides capsule can significantly improve the efficacy, and more secure. ② The introduction of SCL-90 scale efficacy evaluation of FS, the FS symptoms of quantitative, activity observation may be beneficial. ③ HAMA and HAMD scale does not apply to FS diagnosis and efficacy observation.