艾司西酞普兰联合不同剂量米氮平治疗伴焦虑症状抑郁症的效果及安全性分析
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摘要
目的分析艾司西酞普兰联合不同剂量米氮平治疗伴焦虑症状抑郁症的效果及安全性。方法回顾性分析2016年2月—2018年1月108例伴焦虑症状抑郁症患者的临床资料。根据治疗方法将其分为对照组、低剂量组和高剂量组,每组36例。对照组给予艾司西酞普兰治疗,低剂量组和高剂量组在对照组基础上联合米氮平15 mg和30 mg治疗。比较3组治疗前后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)和蒙哥马利抑郁评定量表(MADRS)评分以及临床疗效,记录不良反应发生情况。结果治疗4周和8周时,3组HAMA、HAMD及MADRS评分均较治疗前降低,且低剂量组和高剂量组均低于对照组,高剂量组低于低剂量组(P<0.05)。治疗8周时,3组HAMA、HAMD及MADRS评分均较治疗4周时降低(P<0.05)。高剂量组和低剂量组的临床总有效率高于对照组(P<0.05)。高剂量组体重增加较低剂量组和对照组明显(P<0.05)。结论艾司西酞普兰联合高剂量米氮平能够降低伴焦虑症状抑郁症患者的焦虑和抑郁评分,可明显减轻症状严重程度,但会使患者体重增加。
Objective To analyze efficacy and safety of Escitalopram combined with different doses of Mirtazapine in treatment of patients with depression associated by anxiety. Methods Clinical data of 108 patients with depression associated by anxiety during February 2016 and January 2018 was retrospectively analyzed, and the patients were divided into control group, low-dose group and high-dose group(n=36 for each group) according to therapeutic methods. Control group was treated with Escitalopram, while low-dose and high-dose groups were added with 15 mg and 30 mg Mirtazapine on the basis of treatment for control group. Scores of Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD) and Montgomery-asberg Depression Rating Scale(MADRS) and clinical efficacy were compared before and after treatment, and incidence rates of adverse reactions were recorded among three groups. Results At the 4~(th) and 8~(th) weeks of treatment, HAMA, HAMD and MADRS scores were significantly lower than those before treatment among three groups, and the scores in low-dose and high-dose groups were significantly lower than those in control group, while the scores in high-dose group were significantly lower than those in low-dose group(P<0.05). At the 8~(th) weeks of treatment, HAMA, HAMD and MADRS scores were significantly lower than those at the 4~(th) weeks of treatment among three groups(P<0.05). The total effective rates in high-dose and low-dose groups were significantly higher than that in control group(P<0.05). Value of weight gain in high-dose group was significantly higher than those in low-dose and control groups(P<0.05). Conclusion Escitalopram combined with high-dose Mirtazapine may reduce scores of anxiety and depression and significantly relieve severity of symptoms in treatment of patients with depression associated by anxiety, but it can make gain weight of patients.
Objective To analyze efficacy and safety of Escitalopram combined with different doses of Mirtazapine in treatment of patients with depression associated by anxiety. Methods Clinical data of 108 patients with depression associated by anxiety during February 2016 and January 2018 was retrospectively analyzed, and the patients were divided into control group, low-dose group and high-dose group(n=36 for each group) according to therapeutic methods. Control group was treated with Escitalopram, while low-dose and high-dose groups were added with 15 mg and 30 mg Mirtazapine on the basis of treatment for control group. Scores of Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD) and Montgomery-asberg Depression Rating Scale(MADRS) and clinical efficacy were compared before and after treatment, and incidence rates of adverse reactions were recorded among three groups. Results At the 4~(th) and 8~(th) weeks of treatment, HAMA, HAMD and MADRS scores were significantly lower than those before treatment among three groups, and the scores in low-dose and high-dose groups were significantly lower than those in control group, while the scores in high-dose group were significantly lower than those in low-dose group(P<0.05). At the 8~(th) weeks of treatment, HAMA, HAMD and MADRS scores were significantly lower than those at the 4~(th) weeks of treatment among three groups(P<0.05). The total effective rates in high-dose and low-dose groups were significantly higher than that in control group(P<0.05). Value of weight gain in high-dose group was significantly higher than those in low-dose and control groups(P<0.05). Conclusion Escitalopram combined with high-dose Mirtazapine may reduce scores of anxiety and depression and significantly relieve severity of symptoms in treatment of patients with depression associated by anxiety, but it can make gain weight of patients.
引文
[1] 梁余槟,徐运.N-甲基-D-天冬氨酸受体与抑郁症相关性研究进展[J].中风与神经疾病杂志,2015,32(4):383-384.
[2] 李丛梅,董丽华,王桂红.阿立哌唑口崩片联合度洛西汀治疗老年女性抑郁症伴焦虑患者的疗效及安全性评价[J].中国地方病防治杂志,2017,32(1):82.
[3] 金小苏,许学明,许德河,等.艾司西酞普兰与帕罗西汀治疗单项抑郁症的临床疗效及安全性研究[J].中国临床药理学杂志,2015,31(10):812-814.
[4] 杨凯,刘宇.艾司西酞普兰治疗慢性心力衰竭合并抑郁伴或不伴焦虑的临床观察[J].中国药房,2015,26(12):1632-1634.
[5] 世界卫生组织.ICD-10精神与行为障碍分类临床描述与诊断要点[M].北京:人民卫生出版社,1993:72-89.
[6] 刘丹,李鹏,蒙华庆,等.改良电休克治疗对抑郁症脑结构影响的磁共振成像研究[J].中国心理卫生杂志,2016,30(4):299-305.
[7] 苏晖,施慎逊.5-HT1A受体对抑郁焦虑行为的调节作用及其机制[J].上海交通大学学报:医学版,2015,35(9):1403-1406.
[8] 饶冬萍,陈建华,温全球,等.5-羟色胺1A受体C(-1019)G基因多态性与老年抑郁症和伴有抑郁症状的阿尔茨海默病的关联研究[J].实用医学杂志,2014,30(5):758-760.
[9] 付红勇,王星华,殷盛明.抑郁症分子机制中5-羟色胺2C受体的作用[J].生理科学进展,2014,45(3):221-224.
[10] 慕磊,孙建绪.抑郁症发病机制与抗抑郁药物作用靶标[J].国际药学研究杂志,2015,42(4):463-466.
[11] 司天梅,方贻儒,李涛,等.米氮平治疗抑郁障碍的临床使用[J].中国心理卫生杂志,2014,28(8):634-640.
[12] 徐兵,陈梅,李智,等.米氮平片联合帕罗西汀片治疗女性重度抑郁症的临床研究[J].中国临床药理学杂志,2017,33(3):213-215.
[13] 许著一,徐南飞,徐科君,等.米氮平结合帕潘立酮治疗高血压合并抑郁焦虑症的效果[J].广东医学,2014,35(20):3244-3245.
[14] 顾翠,可秦,张平,等.米氮平联合西酞普兰治疗抑郁症患者睡眠障碍的临床观察[J].中国药房,2017,28(5):670-673.
[15] 欧秋明,邓思灵.米氮平联合草酸艾司西酞普兰片治疗抑郁症的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(13):1252-1254.
[16] 赵小玲,郭文涛,代凤琴.不同剂量米氮平联合草酸艾司西酞普兰片治疗抑郁伴焦虑的疗效分析[J].中国全科医学,2017,20(S1):234-236.
[2] 李丛梅,董丽华,王桂红.阿立哌唑口崩片联合度洛西汀治疗老年女性抑郁症伴焦虑患者的疗效及安全性评价[J].中国地方病防治杂志,2017,32(1):82.
[3] 金小苏,许学明,许德河,等.艾司西酞普兰与帕罗西汀治疗单项抑郁症的临床疗效及安全性研究[J].中国临床药理学杂志,2015,31(10):812-814.
[4] 杨凯,刘宇.艾司西酞普兰治疗慢性心力衰竭合并抑郁伴或不伴焦虑的临床观察[J].中国药房,2015,26(12):1632-1634.
[5] 世界卫生组织.ICD-10精神与行为障碍分类临床描述与诊断要点[M].北京:人民卫生出版社,1993:72-89.
[6] 刘丹,李鹏,蒙华庆,等.改良电休克治疗对抑郁症脑结构影响的磁共振成像研究[J].中国心理卫生杂志,2016,30(4):299-305.
[7] 苏晖,施慎逊.5-HT1A受体对抑郁焦虑行为的调节作用及其机制[J].上海交通大学学报:医学版,2015,35(9):1403-1406.
[8] 饶冬萍,陈建华,温全球,等.5-羟色胺1A受体C(-1019)G基因多态性与老年抑郁症和伴有抑郁症状的阿尔茨海默病的关联研究[J].实用医学杂志,2014,30(5):758-760.
[9] 付红勇,王星华,殷盛明.抑郁症分子机制中5-羟色胺2C受体的作用[J].生理科学进展,2014,45(3):221-224.
[10] 慕磊,孙建绪.抑郁症发病机制与抗抑郁药物作用靶标[J].国际药学研究杂志,2015,42(4):463-466.
[11] 司天梅,方贻儒,李涛,等.米氮平治疗抑郁障碍的临床使用[J].中国心理卫生杂志,2014,28(8):634-640.
[12] 徐兵,陈梅,李智,等.米氮平片联合帕罗西汀片治疗女性重度抑郁症的临床研究[J].中国临床药理学杂志,2017,33(3):213-215.
[13] 许著一,徐南飞,徐科君,等.米氮平结合帕潘立酮治疗高血压合并抑郁焦虑症的效果[J].广东医学,2014,35(20):3244-3245.
[14] 顾翠,可秦,张平,等.米氮平联合西酞普兰治疗抑郁症患者睡眠障碍的临床观察[J].中国药房,2017,28(5):670-673.
[15] 欧秋明,邓思灵.米氮平联合草酸艾司西酞普兰片治疗抑郁症的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(13):1252-1254.
[16] 赵小玲,郭文涛,代凤琴.不同剂量米氮平联合草酸艾司西酞普兰片治疗抑郁伴焦虑的疗效分析[J].中国全科医学,2017,20(S1):234-236.