帕罗西汀联合心理治疗对女性围绝经期情绪障碍、睡眠质量及血清性激素水平的影响
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摘要
目的观察帕罗西汀联合心理治疗对女性围绝经期情绪障碍、睡眠质量及血清性激素水平的影响。方法回顾性分析2016年4月—2018年4月收治的门诊和住院围绝经期患者104例,按照治疗方式分为观察组和对照组,每组52例。观察组给予帕罗西汀联合心理治疗,对照组给予雌激素替代疗法联合心理治疗。持续治疗12周。比较2组情绪障碍、睡眠质量、血清性激素水平、围绝经期症状,并观察2组临床疗效及不良反应发生情况。结果治疗后,2组汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评分均低于治疗前,且观察组HAMD评分低于对照组(P <0. 05)。2组匹兹堡睡眠质量指数(PSQI)评分均低于治疗前,且观察组低于对照组(P <0. 05)。2组血清促卵泡生成素(FSH)、促黄体生成素(LH)水平均低于治疗前,雌二醇(E2)水平高于治疗前(P <0. 05)。2组改良Kupperman评分低于治疗前,且观察组低于对照组(P <0. 05)。观察组总有效率高于对照组,不良反应量表评分低于对照组(P <0. 05)。结论帕罗西汀联合心理治疗用于女性围绝经期治疗中,可以减轻患者情绪障碍,提升睡眠质量,改善血清性激素水平,治疗效果显著,且安全性较高。
Objective To observe effects of Paroxetine combined with psychotherapy on emotional disorder,sleep quality and serum sex hormone levels in women during perimenopausal period. Methods A total of 104 women during perimenopausal period admitted during April 2016 and April 2018 were divided into observation group and control group( n = 52 for each group) according to different therapeutic methods. Observation group was treated with Paroxetine combined with psychotherapy,while control group was treated with estrogen replacement therapy,and times of continuous treatments were 12 weeks. After treatment in two groups,values of emotional disorders,sleep quality,serum sex hormones levels and perimenopausal period symptoms were compared,and efficacy and incidence rate of adverse reactions were observed. Results After treatment,scores of Hamilton anxiety scale( HAMA) and Hamilton rating scale for depression( HAMD) were significantly higher than those before treatment in two groups,and HAMD score in observation group was significantly lower than that in control group( P < 0. 05); scores of Pittsburgh sleep quality index( PSQI) were significantly lower than those before treatment in two groups,and the score in observation group was significantly lower than that in control group( P < 0. 05); levels of follicle stimulating hormone( FSH) and luteinizing hormone( LH) were significantly lower,while estradiol( E2) levels were significantly higher than those before treatment in two groups( P <0. 05); modified Kupperman scores were significantly lower than those before treatment,and the score in observation group was significantly lower than that in control group( P < 0. 05). In observation group,the total effective rate was significantly higher,while treatment emergent symptom scale( TESS) score was significantly lower than those in control group( P < 0. 05). Conclusion Paroxetine combined with psychotherapy in treatment of women during perimenopausal period may reduce emotional disorders,improve sleep quality and levels of serum sex hormones with good efficacy and safety.
Objective To observe effects of Paroxetine combined with psychotherapy on emotional disorder,sleep quality and serum sex hormone levels in women during perimenopausal period. Methods A total of 104 women during perimenopausal period admitted during April 2016 and April 2018 were divided into observation group and control group( n = 52 for each group) according to different therapeutic methods. Observation group was treated with Paroxetine combined with psychotherapy,while control group was treated with estrogen replacement therapy,and times of continuous treatments were 12 weeks. After treatment in two groups,values of emotional disorders,sleep quality,serum sex hormones levels and perimenopausal period symptoms were compared,and efficacy and incidence rate of adverse reactions were observed. Results After treatment,scores of Hamilton anxiety scale( HAMA) and Hamilton rating scale for depression( HAMD) were significantly higher than those before treatment in two groups,and HAMD score in observation group was significantly lower than that in control group( P < 0. 05); scores of Pittsburgh sleep quality index( PSQI) were significantly lower than those before treatment in two groups,and the score in observation group was significantly lower than that in control group( P < 0. 05); levels of follicle stimulating hormone( FSH) and luteinizing hormone( LH) were significantly lower,while estradiol( E2) levels were significantly higher than those before treatment in two groups( P <0. 05); modified Kupperman scores were significantly lower than those before treatment,and the score in observation group was significantly lower than that in control group( P < 0. 05). In observation group,the total effective rate was significantly higher,while treatment emergent symptom scale( TESS) score was significantly lower than those in control group( P < 0. 05). Conclusion Paroxetine combined with psychotherapy in treatment of women during perimenopausal period may reduce emotional disorders,improve sleep quality and levels of serum sex hormones with good efficacy and safety.
引文
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[6]王秋琴,邵婕.低剂量雌激素替代疗法对围绝经期综合征患者激素水平及骨密度的影响[J].实用临床医药杂志,2016,20(24):63-65.
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[9]岳利峰,张恒,奚胜艳,等.基于焦虑抑郁量表评价疏肝调经针灸方案治疗围绝经期情绪障碍的疗效[J].现代中医临床,2016,23(4):1-4.
[10]刘艳,王红艳,宋威,等.帕罗西汀联合丹栀逍遥丸治疗合并睡眠障碍的女性围绝经期抑郁症患者的疗效[J].神经疾病与精神卫生,2016,16(4):434-436.
[11]黄伟玲.帕罗西汀联合克龄蒙对围绝经期抑郁症患者激素水平及神经递质的影响[J].海南医学院学报,2016,22(6):607-610.
[12]杨荣娟,陈丽霞,郭利,等.心理疏导在围绝经期综合征中的应用及对患者内分泌的影响[J].中国妇幼保健,2016,31(24):5420-5422.
[13]杨富菊.奥氮平与齐拉西酮对精神分裂症患者阳性与阴性症状量表、副反应量表评分及疗效的影响比较[J].实用临床医药杂志,2017,21(1):156-158.
[14]张新圆,杨静,王朝华.围绝经期女性情绪障碍与综合干预的疗效分析[J].中国妇产科临床杂志,2017,18(5):422-424.
[15]周会.雌激素替代疗法及心理放松疗法结合艾司西酞普兰对围绝经期中重度抑郁症状的影响[J].河北医学,2016,22(3):481-483.
[16]占晓兰,冯若凡,吴力飞.心理干预对围绝经期妇女睡眠质量和心理健康的影响[J].中国老年学杂志,2016,36(14):3574-3576.
[17]邵红芳,郑燕伟,陶敏芳.围绝经期女性情绪障碍的研究进展[J].世界临床药物,2018,39(3):163-166.
[18]杜玉青,侯红娟.帕罗西汀联合心理干预治疗产后抑郁的临床观察[J].解放军医药杂志,2017,29(6):107-109.
[19]房萌,任艳萍,刘辉,等.重复经颅磁刺激联合帕罗西汀治疗重性抑郁障碍[J].首都医科大学学报,2014,35(2):194-199.
[20]徐桂绚,孔令恩,史文俊.帕罗西汀治疗冠心病合并抑郁症疗效观察[J].中华保健医学杂志,2012,14(3):238-239.
[21]夏松柏,虞冬辉.甜梦口服液联合帕罗西汀治疗围绝经期抑郁症的临床观察[J].中国药房,2017,28(3):344-347.
[22]汤珏瑶,曹耀萍,郭梅,等.心理护理对围绝经期综合征患者不良情绪及睡眠的作用[J].国际精神病学杂志,2016,43(3):536-538.
[2]郑燕伟,陶敏芳.围绝经期女性睡眠障碍的研究进展[J].上海交通大学学报:医学版,2016,36(7):1088-1092.
[3]孙艳格,阮祥燕,Alfred O Mueck.围绝经期及绝经后妇女心血管疾病危险因素的变化[J].首都医科大学学报,2016,37(4):413-417.
[4]雷鹏琼,李彦洁.身心疗法对围绝经期症状影响的研究进展[J].中国老年学杂志,2016,36(21):5467-5470.
[5]李方凤.低剂量雌激素替代疗法对围绝经期综合征患者激素水平的影响[J].实用临床医药杂志,2017,21(1):130-131.
[6]王秋琴,邵婕.低剂量雌激素替代疗法对围绝经期综合征患者激素水平及骨密度的影响[J].实用临床医药杂志,2016,20(24):63-65.
[7]曹泽毅.中华妇产科学[M]. 3版.北京:人民卫生出版社,2014:2537.
[8]朱晓璐,李萍,孙东梅,等.上海徐汇区中年妇女围绝经期症状调查[J].中国妇幼健康研究,2016,27(1):38-41.
[9]岳利峰,张恒,奚胜艳,等.基于焦虑抑郁量表评价疏肝调经针灸方案治疗围绝经期情绪障碍的疗效[J].现代中医临床,2016,23(4):1-4.
[10]刘艳,王红艳,宋威,等.帕罗西汀联合丹栀逍遥丸治疗合并睡眠障碍的女性围绝经期抑郁症患者的疗效[J].神经疾病与精神卫生,2016,16(4):434-436.
[11]黄伟玲.帕罗西汀联合克龄蒙对围绝经期抑郁症患者激素水平及神经递质的影响[J].海南医学院学报,2016,22(6):607-610.
[12]杨荣娟,陈丽霞,郭利,等.心理疏导在围绝经期综合征中的应用及对患者内分泌的影响[J].中国妇幼保健,2016,31(24):5420-5422.
[13]杨富菊.奥氮平与齐拉西酮对精神分裂症患者阳性与阴性症状量表、副反应量表评分及疗效的影响比较[J].实用临床医药杂志,2017,21(1):156-158.
[14]张新圆,杨静,王朝华.围绝经期女性情绪障碍与综合干预的疗效分析[J].中国妇产科临床杂志,2017,18(5):422-424.
[15]周会.雌激素替代疗法及心理放松疗法结合艾司西酞普兰对围绝经期中重度抑郁症状的影响[J].河北医学,2016,22(3):481-483.
[16]占晓兰,冯若凡,吴力飞.心理干预对围绝经期妇女睡眠质量和心理健康的影响[J].中国老年学杂志,2016,36(14):3574-3576.
[17]邵红芳,郑燕伟,陶敏芳.围绝经期女性情绪障碍的研究进展[J].世界临床药物,2018,39(3):163-166.
[18]杜玉青,侯红娟.帕罗西汀联合心理干预治疗产后抑郁的临床观察[J].解放军医药杂志,2017,29(6):107-109.
[19]房萌,任艳萍,刘辉,等.重复经颅磁刺激联合帕罗西汀治疗重性抑郁障碍[J].首都医科大学学报,2014,35(2):194-199.
[20]徐桂绚,孔令恩,史文俊.帕罗西汀治疗冠心病合并抑郁症疗效观察[J].中华保健医学杂志,2012,14(3):238-239.
[21]夏松柏,虞冬辉.甜梦口服液联合帕罗西汀治疗围绝经期抑郁症的临床观察[J].中国药房,2017,28(3):344-347.
[22]汤珏瑶,曹耀萍,郭梅,等.心理护理对围绝经期综合征患者不良情绪及睡眠的作用[J].国际精神病学杂志,2016,43(3):536-538.