目的 比较度洛西汀和氟哌噻吨美利曲辛片治疗抑郁症伴躯体疼痛障碍的临床疗效。方法 选取2013年6月-2016年12月在北京市石景山区五里坨医院接受治疗的抑郁症伴躯体疼痛障碍患者128例，随机分为对照组和治疗组，每组各64例。脱落10例，实际完成118例，对照组58例，治疗组60例。对照组患者口服氟哌噻吨美利曲辛片，起始剂量为1片/d，2周内加至治疗剂量4片/d。治疗组在对照组的基础上口服度洛西汀肠溶片，起始剂量为10 mg/d，2周内加至治疗剂量60mg/d。两组患者均连续治疗8周。观察两组的临床疗效，比较两组的HAMD和HAMA评分、SF-MPQ评分和不良反应情况。结果 治疗后，对照组和治疗组的显效率分别为17.24%、86.76%，有效率分别为87.93%、96.76%，两组显效率比较差异有统计学意义（P<0.01），两组有效率比较差异无统计学意义。治疗8周后，对照组的HAMD和HAMA评分均显著降低，治疗4、8周后，治疗组HAMD和HAMA评分均显著降低，治疗前后比较差异具有统计学意义（P<0.01）；且治疗组的上述评分显著低于同期对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组的情感PRI评分和总PRI评分均显著降低，且治疗组的感觉PRI评分、VAS评分和PPI评分均显著降低，同组治疗前后比较差异具有统计学意义（P<0.01）；且治疗后治疗组的SF-MPQ评分低于对照组，两组比较差异具有统计学意义（P<0.05）。两组均未出现严重药物不良反应。结论 与氟哌噻吨美利曲辛片相比，度洛西汀治疗抑郁症伴躯体疼痛起效快，药效更好，药物安全性高。

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.