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一项多中心、双盲、随机研究,比较薰衣草油制剂 Silexan 与劳拉西泮治疗广泛性焦虑症。

A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder.

机构信息

Surgery for psychiatry and psychotherapy, Buseck-Beuern, Germany.

出版信息

Phytomedicine. 2010 Feb;17(2):94-9. doi: 10.1016/j.phymed.2009.10.006. Epub 2009 Dec 3.

Abstract

Generalized and persistent anxiety, accompanied by nervousness and other symptoms (Generalised Anxiety Disorder, GAD) is frequent in the general population and leads to benzodiazepine usage. Unfortunately, these substances induce sedation and have a high potential for drug abuse, and there is thus a need for alternatives. As the anxiolytic properties of lavender have already been demonstrated in pharmacological studies and small-scale clinical trials, it was postulated that lavender has a positive effect in GAD. A controlled clinical study was then performed to evaluate the efficacy of silexan, a new oral lavender oil capsule preparation, versus a benzodiazepine. In this study, the efficacy of a 6-week-intake of silexan compared to lorazepam was investigated in adults with GAD. The primary target variable was the change in the Hamilton Anxiety Rating Scale (HAM-A-total score) as an objective measurement of the severity of anxiety between baseline and week 6. The results suggest that silexan effectively ameliorates generalized anxiety comparable to a common benzodiazepine (lorazepam). The mean of the HAM-A-total score decreased clearly and to a similar extent in both groups (by 11.3+/-6.7 points (45%) in the silexan group and by 11.6+/-6.6 points (46%) in the lorazepam group, from 25+/-4 points at baseline in both groups). During the active treatment period, the two HAM-A subscores "somatic anxiety" (HAM-A subscore I) and "psychic anxiety" (HAM-A subscore II) also decreased clearly and to a similar extent in both groups. The changes in other subscores measured during the study, such as the SAS (Self-rating Anxiety Scale), PSWQ-PW (Penn State Worry Questionnaire), SF 36 Health survey Questionnaire and Clinical Global Impressions of severity of disorder (CGI item 1, CGI item 2, CGI item 3), and the results of the sleep diary demonstrated comparable positive effects of the two compounds. In conclusion, our results demonstrate that silexan is as effective as lorazepam in adults with GAD. The safety of silexan was also demonstrated. Since lavender oil showed no sedative effects in our study and has no potential for drug abuse, silexan appears to be an effective and well tolerated alternative to benzodiazepines for amelioration of generalised anxiety.

摘要

广泛性焦虑症(Generalised Anxiety Disorder,GAD)是一种常见的精神疾病,其特征为持续性焦虑,并伴有紧张等其他症状,会导致人们使用苯二氮䓬类药物。然而,这些药物会引起镇静作用,且具有较高的药物滥用风险,因此需要寻找替代品。鉴于薰衣草的镇静功效已经在药理学研究和小型临床试验中得到证实,研究人员推测薰衣草可能对 GAD 具有积极作用。为此,开展了一项对照临床试验,旨在评估新型口服薰衣草油胶囊制剂西来普森(silexan)对 GAD 的疗效,并将其与苯二氮䓬类药物进行比较。

该研究纳入了成年人 GAD 患者,比较了为期 6 周的西来普森与劳拉西泮的疗效。主要疗效指标为基线至第 6 周期间汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale,HAM-A)总分的变化,这是评估焦虑严重程度的客观指标。

研究结果表明,西来普森可有效改善广泛性焦虑,其疗效与常用苯二氮䓬类药物(劳拉西泮)相当。两组患者的 HAM-A 总分均明显下降,且下降程度相似(西来普森组下降 11.3±6.7 分(45%),劳拉西泮组下降 11.6±6.6 分(46%),基线时两组 HAM-A 总分均为 25±4 分)。在治疗期间,两组的 HAM-A 两个亚量表(躯体焦虑亚量表 I 和精神焦虑亚量表 II)也明显下降,且下降程度相似。研究期间测量的其他亚量表(如状态焦虑量表 SAS、Penn State 担忧问卷 PSWQ-PW、SF-36 健康调查量表和疾病严重程度的临床总体印象 CGI 项目 1、CGI 项目 2、CGI 项目 3)以及睡眠日记的结果也显示,两种药物具有相似的积极作用。

综上,本研究结果表明,西来普森治疗成人 GAD 的疗效与劳拉西泮相当,且安全性良好。鉴于本研究中薰衣草油无镇静作用且无药物滥用风险,西来普森似乎是一种有效且耐受良好的苯二氮䓬类药物替代药物,可用于改善广泛性焦虑。

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