目的:评估多维干预模式治疗抑郁症患者疼痛症状的疗效及成本-效果分析.方法:60例抑郁症患者,疼痛持续3个月以上,随机分为多维干预组(MI组)和药物治疗组(DT组),治疗8周,采用汉密顿抑郁量表(Hamilton Depression Scale,HAMD17)评估抗抑郁疗效,采用视觉模拟评分法(Visual Analog Scale,VAS)评估镇痛疗效,应用大体评定量表(General Assessment Scale,GAS)计算有效率和成本效果比,了解每获得1%有效率所需成本.结果:60例伴有疼痛症状的抑郁症患者,男23例,女37例,经过8周治疗,多维干预组患者的HAMD17和VAS评分显著优于药物治疗组,成本效果分析显示,尽管认知行为治疗和生物反馈治疗导致成本增加,但是每获得1%有效率所需成本仍显著低于药物治疗组.结论:多维干预模式治疗抑郁症患者的疼痛症状疗效更佳,且具有更好的经济学价值.
Objective: To assess the efficacy and cost-effectiveness of Multidimensional Intervention (MI) in treating pain symptoms in depression patients. Methods: 60 depression patients suffering pain symptoms for over 3 months were randomized into the multidimensional intervention group ( MI group ) and the drug treatment group (DT group) and were treated for 8 weeks. The Hamilton Depression Scale (HAMD17), the Visual Analog Scale (VAS) and the General Assessment Scale (GAS) were used to assess depression, analgesic effect and the cost-effectiveness respectively. Results: Sixty (23 males and 37 females) first- episode depression patients with pain symptoms were enrolled. After 8 weeks of treatment, the MI group had a significantly lower total score on the VAS than the DT group. The health economics analysis showed that the cost was higher in the MI group than in the DT group. However, the cost-effectiveness ratio, defined as the cost required to obtain 1% effective rate, was still significantly lower in the MI group than in the DT group. Conclusion: The multidimensional intervention seems to be more effective, and has better economic value than antidepressant treatment for pain symptoms in depression patients.