度洛西汀与帕罗西汀治疗老年期抑郁症临床对照研究

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【摘要】 目的:比较度洛西汀与帕罗西汀治疗老年期抑郁症的疗效及安全性。方法:将60例老年期抑郁症患者随机分为度洛西汀组与帕罗西汀组,疗程8周,采用汉密尔顿抑郁量表(HAMD)评定临床疗效,副反应量表(TESS)评定不良反应。结果:度洛西汀组与帕罗西汀组总体疗效相当,度洛西汀起效较快,两组不良反应均较轻。结论:度洛西汀与帕罗西汀都是治疗老年期抑郁症较理想的药物,与帕罗西汀相比,度洛西汀治疗伴有躯体症状的抑郁症患者疗效更好。

【关键词】 老年期抑郁症; 度洛西汀; 帕罗西汀

Controlled Study of Duloxetine and Paroxitine in Treatment of Patients with Senile Depression/ZHAO Fang-quan.//Medical Innovation of China,2012,9(28):031-032

【Abstract】 Objective:To compare the efficacy and safety of duloxetine and paroxitine in the treatment of patients with senile depression.Method:60 patients with senile depression were divided into two groups who treatment with duloxetine or paroxitine for eight weeks.The efficacy was evaluated by Hamilton depressive scale(HAMD),safety was evaluated by treatment emergant symptom scale(TESS).Result:The efficacies of duloxetine and paroxitine in treatment of patients with senile depression were similar.They had no significant differences between two groups,Both of them took effect more quickly and their side effects were less and mild.Conclusion:It suggests that both duloxetine and paroxitine might be recommended as appropriated drugs in the treatment of senile depression.Du loxetine shows better efficacy than parox itine in the patients with somatic symptoms1.

【Key words】 Senile depression; Duloxetine; Paroxitine

First-author’s address:Shenyang Mental Health Center,Shenyang 110168,China

doi:10.3969/j.issn.1674-4985.2012.28.017

度洛西汀是5-羟色胺和去甲肾上腺素双重再摄取抑制剂,而帕罗西汀是选择性5-羟色胺再摄取抑制剂,本试验以帕罗西汀作对照,对度洛西汀在治疗老年期抑郁症的疗效及安全性进行研究,了解其疗效和安全性,现报告如下。

1 资料与方法

1.1 一般资料 选择本中心2010年6月-2011年12月门诊或住院治疗的60例抑郁症患者,年龄≥60岁,符合精神与行为障碍分类临床描述与诊断要点(ICD-10)抑郁发作或双相情感障碍抑郁相的诊断标准;汉密尔顿抑郁量表(HAMD)17项评分≥18分,排除有严重躯体疾病者、有药物依赖者、有严重自杀企图及行为者以及药物过敏者。按照就诊顺序随机分为两组,度洛西汀组30例,男18例,女12例;平均年龄(65.3±4.6)岁;病程1~28个月,平均(14.2±5.3)个月。帕罗西汀组30例,男15例,女15例;平均年龄(66.5±5.1)岁;病程1~30个月,平均(15.8±7.8)个月。两组一般情况比较差异无统计学意义(P>0.05),具有可比性。

1.2 治疗方法 清洗期1周。度洛西汀起始剂量30 mg/d,睡前服,1周内加至60 mg/d,平均(39.5±10.6)mg/d。帕罗西汀起始剂量20 mg/d,2周内加至40~60 mg/d,平均(108.6±27.3)mg/d。疗程8周。有失眠者可合用阿普唑仑及艾司唑仑。

1.3 辅助检查 血、尿常规,肝、肾功能,血糖,心电图在治疗前、治疗中、治疗结束时各检查1次。

1.4 疗效评定 采用汉密尔顿抑郁量表(HAMD)、副反应量表(TESS)评定临床疗效及不良反应,分别在基线和治疗1、2、4、8周各评定1次,一致性测定Kappa=0.82。临床疗效按照HAMD减分率,≥75%为痊愈,≥50%为显著进步,≥25%为进步,

1.5 统计学处理 采用SPSS 10.0软件对数据统计处理,计量资料以(x±s)表示,采用t检验,计数资料采用 字2检验,以P

2 结果

2.1 疗效比较 度洛西汀组痊愈19例,显著进步6例,进步4例,无效1例,显效率83.3%;帕罗西汀组痊愈18例,显著进步6例,进步3例,无3效例,显效率80.0%,两组间比较差异无统计学意义(P>0.05)。

2.2 两组HMAD评分比较 度洛西汀组与帕罗西汀组治疗后HMAD评分与治疗前比较均显著下降(P