舍曲林合并无抽搐电休克治疗老年抑郁症临床研究
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- 英文论文题名：Modified electroconvulsive therapy combined with sertraline in treatment of elderly patient swith major depression
- 论文作者：姜小琴 ; 杨开仁 ; 郑利锋 ; 周波 ; 杨志 ; 王梅 ; 郑芳
- 英文论文作者：Jiang Xiaoqin ; Yang Kairen ; Zheng Lifeng ; Zhou Bo ; Yang Zhi ; Wang Mei ; Zheng Fang ; The Third Hospital of Quzhou
- 年：2014
- 作者机构：衢州市第三医院精神科;
- 论文关键词：无抽搐电休克治疗 ; 舍曲林 ; 老年抑郁症
- 英文论文关键词：Modified electroconvulsive therapy ; Sertraline ; Elderly patients with major depression
- 会议召开时间：2014-11-20
- 会议录名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会论文汇编
- 语种：中文
- 分类号：R749.4
- 学会代码：ZJKX
- 会议名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会
- 会议地点：中国浙江湖州
- 主办单位：浙江省医学会精神病学分会（The Society of Psychiatry ; ZJMA）、浙江省医师协会精神科医师分会
- 学会名称：浙江省科学技术协会
- 页数：4
- 文件大小：341k
- 原文格式：O
- 会议级别：地方
摘要
目的了解舍曲林合并无抽搐电休克治疗(MECT)对老年抑郁症患者的疗效与不良反应。方法对83例符合老年抑郁症的患者按随机数字表法分为研究组41例和对照组42例,研究组给予舍曲林合并MECT治疗,对照组单用舍曲林治疗,观察8周。分别于治疗前、治疗后第1、2、4和8周末时采用汉密尔顿抑郁量表(HAM D 17)评定疗效,不良反应症状量表(TESS)评定不良反应。研究组治疗前后采用临床记忆量表甲套评定认知功能。结果研究组脱落7例,对照组脱落5例。研究组治疗后第1、2、4、8周末时的HAM D 17总分较治疗前显著下降(P<0.05),对照组治疗第2、4、8周末HAM D 17总分较治疗前下降(P<0.05)。两组间治疗后第2周末时HAM D 17总分比较差异有统计学意义(P<0.05)。研究组治疗后第1个24h临床记忆量表甲套中指向记忆、图像自由回忆项目分较治疗前下降(均P<0.05),治疗第2周末联想学习、无意义图形再认项目分及记忆商值较治疗前升高(均P<0.05),治疗第8周末除图像自由回忆项目分外,其它项目分及记忆商值较治疗前升高(P<0.05或0.01)。研究组HAM D减分率(76.23±21.41)%,临床总有效率85.29%,临床痊愈率47.06%;对照组HAMD减分率(51.26±18.13)%,临床总有效率64.86%,临床痊愈率21.62%,两组间差异均有统计学意义(均P<0.05)。两组患者各时点的TESS评分比较差异无统计学意义(P>0.05)。结论抗抑郁药物合并M ECT治疗能提高老年抑郁症的疗效,无严重不良反应。
Objective To evaluate the efficacy and safety of modified electroconvul sivetherapy(MECT)combined with sertraline in treatment of elderly patients with major depression.Methods Eighty three elderly patients with major depression were randomly assigned toreceive MECT combined with sertraline(trial group,n=41)or sertraline(control group,n=42)for 8 weeks.The Hamilton Rating Seale for Depression(HAMD)and Treatment Emergent Symptom Scale(TESS)were used to measure therapeutic efficacy and side effects.The Clinical Memory Seale was used to evaluate cognitive functions priorto and post the treatment.Results HAMD score decreased 1 week after treatment intrial group,which was notsignificantly different to that of control group,while HAMD score intrial group was decreased more markedly thant hat of control group at the end of week 2.The directing memory and image free recollection of Clinical Memory Scale intrial group were deerease 24 h after treatment(P < 0.05),the scale scores and memory scores were increased significant lyat the end of weeks 8(P < 0.05 or P < 0.01).There were significant differences in the deereasing rate of HAMD score(76.23 ± 21.41%vs 51.26 ± 18.13%,P < 0.05),the response rate(85.29%vs64.86%,P < 0.05)and the recovery rate(47.06%vs21.62%,P < 0.05)between two groups.There was nosignificant difference in TESS scores between two groups(P > 0.05).Conclusion MECT combined with sertraline can improve efficacy for elderly patient swith major depression and notincr ease the side effects.
Objective To evaluate the efficacy and safety of modified electroconvul sivetherapy(MECT)combined with sertraline in treatment of elderly patients with major depression.Methods Eighty three elderly patients with major depression were randomly assigned toreceive MECT combined with sertraline(trial group,n=41)or sertraline(control group,n=42)for 8 weeks.The Hamilton Rating Seale for Depression(HAMD)and Treatment Emergent Symptom Scale(TESS)were used to measure therapeutic efficacy and side effects.The Clinical Memory Seale was used to evaluate cognitive functions priorto and post the treatment.Results HAMD score decreased 1 week after treatment intrial group,which was notsignificantly different to that of control group,while HAMD score intrial group was decreased more markedly thant hat of control group at the end of week 2.The directing memory and image free recollection of Clinical Memory Scale intrial group were deerease 24 h after treatment(P < 0.05),the scale scores and memory scores were increased significant lyat the end of weeks 8(P < 0.05 or P < 0.01).There were significant differences in the deereasing rate of HAMD score(76.23 ± 21.41%vs 51.26 ± 18.13%,P < 0.05),the response rate(85.29%vs64.86%,P < 0.05)and the recovery rate(47.06%vs21.62%,P < 0.05)between two groups.There was nosignificant difference in TESS scores between two groups(P > 0.05).Conclusion MECT combined with sertraline can improve efficacy for elderly patient swith major depression and notincr ease the side effects.
引文
[1]Chen R,Copeland JR,Wei L.A meta-analysis of epidemiological studies in depression of older people in the People,s Republic of China[J].Int J Geriatr Psychiatry,1999,14(10):821-830.
[2]范穗强,孟春想,洪雨.中青年与老年抑郁症患者临床特征及药物治疗的对比研究[J].实用临床医药杂志,2012,16(7):56-59.
[3]Cole MG,Dendukun N.Risk factors for depression among elderly community subjects[J].Am J Psychiatry,2003,160(6):l 147-1156.
[4]SANFORD I.老年精神药理学研究[J].中国心理卫生杂志.1999,13(5):183-285.
[5]范肖冬,汪向东,于欣等译.ICD-10精神与行为障碍分类第十版[M].人民卫生出版社,1993,97-98.
[6]张明园.精神科评定量表手册[M].湖南科学技术出版社,2003,121-126;184-188;197-202
[7]刘学俊,邹义壮,刘继庆,等.临床记忆量表多媒体测查方法与手工操作结果的比较[J].中国心理卫生杂志,20026,1(9):640-641.
[8]Cole MG,Elie LM,McCusker J,et al.Feasibility and effectiveness of treatments for depression in elderly medical inpatients,Int Psychogeriatr,2000,12(4):453-461.
[9]杨开仁,姜小琴,毛福荣,等.老年抑郁症患者预后相关因素研究[J].浙江医学,2013,35(12):1602-1605.
[10]张新凯,翁巍骏,卢虹,等.电抽搐治疗精神疾病的发现与发展简史[J].中华医史杂志.2001,31(4):213—216.
[11]van der WURFF FB,STEK ML,HOOGENDIJK WJ.The efficacy and safety of ECT in depressed older adults:a literature reviewfj].Int J Geriatr Psychiatry,2003,18(10):894-904.
[12]李冠军,苏亮,李华芳.老年抑郁症治疗方案分析[J].中国新药与临床杂志,2005,24(8):630-632.
[13]姜小琴,杨开仁,毛福荣,等.无抽搐电休克治疗抑郁症急性期临床疗效分析[J].中国全科医学,2009,12(6B):1054-1056.
[14]俞丽华,胡斌,刘铁桥.老年抑郁症的研究进展[J].临床精神医学杂志,201 1,21(4):283-284.
[15]高红艳,郭本玉,陈翔,等.无抽搐电休克治疗老年抑郁症患者的非匹性负波的变化观察[J].神经病学与神经康复学杂志,2012,9(3):115-117.
[16]闫芳,李淑然.老年抑郁症的发病率及其随访研究[J].中国心理卫生杂志,2000,14(6):392-394.
[2]范穗强,孟春想,洪雨.中青年与老年抑郁症患者临床特征及药物治疗的对比研究[J].实用临床医药杂志,2012,16(7):56-59.
[3]Cole MG,Dendukun N.Risk factors for depression among elderly community subjects[J].Am J Psychiatry,2003,160(6):l 147-1156.
[4]SANFORD I.老年精神药理学研究[J].中国心理卫生杂志.1999,13(5):183-285.
[5]范肖冬,汪向东,于欣等译.ICD-10精神与行为障碍分类第十版[M].人民卫生出版社,1993,97-98.
[6]张明园.精神科评定量表手册[M].湖南科学技术出版社,2003,121-126;184-188;197-202
[7]刘学俊,邹义壮,刘继庆,等.临床记忆量表多媒体测查方法与手工操作结果的比较[J].中国心理卫生杂志,20026,1(9):640-641.
[8]Cole MG,Elie LM,McCusker J,et al.Feasibility and effectiveness of treatments for depression in elderly medical inpatients,Int Psychogeriatr,2000,12(4):453-461.
[9]杨开仁,姜小琴,毛福荣,等.老年抑郁症患者预后相关因素研究[J].浙江医学,2013,35(12):1602-1605.
[10]张新凯,翁巍骏,卢虹,等.电抽搐治疗精神疾病的发现与发展简史[J].中华医史杂志.2001,31(4):213—216.
[11]van der WURFF FB,STEK ML,HOOGENDIJK WJ.The efficacy and safety of ECT in depressed older adults:a literature reviewfj].Int J Geriatr Psychiatry,2003,18(10):894-904.
[12]李冠军,苏亮,李华芳.老年抑郁症治疗方案分析[J].中国新药与临床杂志,2005,24(8):630-632.
[13]姜小琴,杨开仁,毛福荣,等.无抽搐电休克治疗抑郁症急性期临床疗效分析[J].中国全科医学,2009,12(6B):1054-1056.
[14]俞丽华,胡斌,刘铁桥.老年抑郁症的研究进展[J].临床精神医学杂志,201 1,21(4):283-284.
[15]高红艳,郭本玉,陈翔,等.无抽搐电休克治疗老年抑郁症患者的非匹性负波的变化观察[J].神经病学与神经康复学杂志,2012,9(3):115-117.
[16]闫芳,李淑然.老年抑郁症的发病率及其随访研究[J].中国心理卫生杂志,2000,14(6):392-394.