阿戈美拉汀治疗抑郁障碍的疗效及对脑源性神经营养因子的影响
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摘要
目的:探讨阿戈美拉汀治疗抑郁障碍的疗效及对脑源性神经营养因子(BDNF)的影响。方法:选取2018年3月至2018年12月本院收治的抑郁症患者90例,随机分为观察组和对照组各45例,观察组接受阿戈美拉汀治疗,对照组接受文拉法辛治疗,4周后观察两组临床疗效、BDNF水平以及不良反应。结果:观察组有效率为73.33%,对照组有效率为62.22%,两组有效率比较差异无统计学意义(P>0.05);治疗后两组HAMD、HAMA评分较治疗前明显降低(P<0.05),观察组HAMD评分明显低于对照组(P<0.05),HAMA评分明显高于对照组(P<0.05);治疗后两组BDNF水平较治疗前明显升高(P<0.05),且观察组明显高于对照组(P<0.05);Pearson相关性分析显示,BDNF与HAMD、HAMA评分呈负相关(P<0.05),与HAMD减分率呈正相关(P<0.05);两组不良反应比较差异无统计学意义(P>0.05)。结论:阿戈美拉汀能够有效改善患者抑郁和焦虑症状,显著降低BDNF水平,具有较好的安全性。
AIM: To investigate the efficacy of agomelatine in the treatment of depressive disorder and its effect on brain-derived neurotrophic factor(BDNF). METHODS: A total of 90 patients with depression admitted to our hospital from March 20 to December 2018 were randomly divided into observation group(45 cases) and control group(45 cases). The observation group was treated with agomelatine, the control group was treated with venlafaxine, and the clinical efficacy, BDNF level and adverse reactions were observed after 4 weeks. RESULTS:The effective rate of the observation group was 73.33% and the effective rate of the control group was 62.22%. There was no significant difference in the effective rate between the two groups(P>0.05). The HAMD and HAMA scores of the two groups were significantly lower than those before treatment(P<0.05), the HAMD scores of the observation group were significantly lower than those of the control group(P<0.05), and the HAMA scores of the observation group were significantly higher than the control group(P<0.05). Pearson correlation analysis showed that BDNF level was negatively correlated with HAMD and HAMA scores(P<0.05), and positively correlated with HAMD reduction rate(P<0.05). There was no significant difference in adverse reactions between the two groups(P>0.05).CONCLUSION:Agomelatine can effectively improve the symptoms of depression and anxiety, significantly reduce the level of BDNF and has better safety.
AIM: To investigate the efficacy of agomelatine in the treatment of depressive disorder and its effect on brain-derived neurotrophic factor(BDNF). METHODS: A total of 90 patients with depression admitted to our hospital from March 20 to December 2018 were randomly divided into observation group(45 cases) and control group(45 cases). The observation group was treated with agomelatine, the control group was treated with venlafaxine, and the clinical efficacy, BDNF level and adverse reactions were observed after 4 weeks. RESULTS:The effective rate of the observation group was 73.33% and the effective rate of the control group was 62.22%. There was no significant difference in the effective rate between the two groups(P>0.05). The HAMD and HAMA scores of the two groups were significantly lower than those before treatment(P<0.05), the HAMD scores of the observation group were significantly lower than those of the control group(P<0.05), and the HAMA scores of the observation group were significantly higher than the control group(P<0.05). Pearson correlation analysis showed that BDNF level was negatively correlated with HAMD and HAMA scores(P<0.05), and positively correlated with HAMD reduction rate(P<0.05). There was no significant difference in adverse reactions between the two groups(P>0.05).CONCLUSION:Agomelatine can effectively improve the symptoms of depression and anxiety, significantly reduce the level of BDNF and has better safety.
引文
[1] 林芳波,侯德仁,唐秋萍.抑郁症的药物治疗进展及艾氯胺酮的应用前景[J].南方医科大学学报,2017,37(4):567-569.
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[9] 宁征远,谢姗姗,李健,等.阿戈美拉汀联合坦度螺酮对老年抑郁症患者血清NE、5-HT水平的影响[J].东南国防医药,2017,19(3):251-253.
[10] 杨晓钟,马雯霞.5-HT再摄取抑制剂对抑郁症患者睡眠质量和疗效的影响[J].河北医学,2018,24(10):1630-1634.
[11] 周严灿,平晶,单建敏.乌灵胶囊联合阿戈美拉汀对女性抑郁伴睡眠障碍患者的疗效及对神经递质和内分泌激素的影响[J].中国临床药理学与治疗学,2018,23(12):1415-1419.
[12] Gupta K,Gupta R,Bhatia MS,et al.Effect of agomelatine and fluoxetine on hamd score,serum brain-derived neurotrophic factor,and tumor necrosis factor-α level in patients with major depressive disorder with severe depression[J].J Clin Pharmacol,2017,57(12):1519-1526.
[13] Kennedy SH,Heun R,Avedisova A,et al.Effect of agomelatine 25-50 mg on functional outcomes in patients with major depressive disorder[J].J Affect Disord,2018,238:122-128.
[14] 孙毅,卓越,吕治宇,等.不同剂量文拉法辛与阿戈美拉汀治疗难治性抑郁症的疗效观察[J].临床合理用药杂志,2018,11(11):39-40.
[15] 杨志,迟强,栾中山.阿戈美拉汀与文拉法辛治疗抑郁症的临床对照研究[J].神经损伤与功能重建,2015,10(4):356-357.
[16] 李正华.文拉法辛缓释片治疗广泛性焦虑症对照研究[J].精神医学杂志,2012,25(3):195-196.
[17] Weinmann S,Becker T,Koesters M.Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI:meta-analysis[J].Psychopharmacology(Berl),2008,196(4):511-520.
[18] 胡晓蕊,沈宗霖,许秀峰.脑源性神经营养因子与抑郁症关系的研究[J].临床精神医学杂志,2017,27(2):137-139.
[19] 杨和增,单菲,李敏智.围绝经期抑郁症患者文拉法辛治疗前后脑源性神经营养因子的变化[J].实用医学杂志,2018,34(3):457-459.
[20] 关书,熊伟,高云.脑源性神经营养因子与抑郁症[J].中国药理学通报,2018,34(2):153-156.
[21] 公维谦,陈玉社,赵燕,等.抑郁症合并2型糖尿病患者血浆BDNF水平与抑郁焦虑症状、TG的相关性[J].国际精神病学杂志,2017,44(3):398-400+403.
[22] 汪卫华,刘丽,李光耀,等.抑郁症患者血清瘦素和脑源性神经营养因子与疗效的相关性[J].临床精神医学杂志,2015,25(5):332-334.
[2] 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.
[3] 熊丽丽,姬劲峰.帕罗西汀与文拉法辛治疗首发抑郁症的效果比较[J].实用医药杂志,2017,34(2):142-143.
[4] 曹曙光.文拉法辛和米氮平治疗难治性抑郁症的效果比较[J].中国医药指南,2017,15(31):136-137.
[5] 许峰,王建民,焦宗久,等.不同剂量文拉法辛与阿戈美拉汀治疗难治性抑郁症的疗效分析[J].国际精神病学杂志,2017,44(1):82-84+101.
[6] 牛娟,陈晓芹,周田田,等.阿戈美拉汀治疗首发老年抑郁症的疗效研究[J].国际精神病学杂志,2018,45(1):65-67.
[7] 郭俊慧,王高华,朱志先,等.脑源性神经营养因子对重症抑郁及其认知功能障碍的影响[J].神经损伤与功能重建,2017,12(6):526-528.
[8] 卢瑾,李凌江,许秀峰.中国抑郁障碍防治指南(第二版)解读:评估与诊断[J].中华精神科杂志,2017,50(3):169-171.
[9] 宁征远,谢姗姗,李健,等.阿戈美拉汀联合坦度螺酮对老年抑郁症患者血清NE、5-HT水平的影响[J].东南国防医药,2017,19(3):251-253.
[10] 杨晓钟,马雯霞.5-HT再摄取抑制剂对抑郁症患者睡眠质量和疗效的影响[J].河北医学,2018,24(10):1630-1634.
[11] 周严灿,平晶,单建敏.乌灵胶囊联合阿戈美拉汀对女性抑郁伴睡眠障碍患者的疗效及对神经递质和内分泌激素的影响[J].中国临床药理学与治疗学,2018,23(12):1415-1419.
[12] Gupta K,Gupta R,Bhatia MS,et al.Effect of agomelatine and fluoxetine on hamd score,serum brain-derived neurotrophic factor,and tumor necrosis factor-α level in patients with major depressive disorder with severe depression[J].J Clin Pharmacol,2017,57(12):1519-1526.
[13] Kennedy SH,Heun R,Avedisova A,et al.Effect of agomelatine 25-50 mg on functional outcomes in patients with major depressive disorder[J].J Affect Disord,2018,238:122-128.
[14] 孙毅,卓越,吕治宇,等.不同剂量文拉法辛与阿戈美拉汀治疗难治性抑郁症的疗效观察[J].临床合理用药杂志,2018,11(11):39-40.
[15] 杨志,迟强,栾中山.阿戈美拉汀与文拉法辛治疗抑郁症的临床对照研究[J].神经损伤与功能重建,2015,10(4):356-357.
[16] 李正华.文拉法辛缓释片治疗广泛性焦虑症对照研究[J].精神医学杂志,2012,25(3):195-196.
[17] Weinmann S,Becker T,Koesters M.Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI:meta-analysis[J].Psychopharmacology(Berl),2008,196(4):511-520.
[18] 胡晓蕊,沈宗霖,许秀峰.脑源性神经营养因子与抑郁症关系的研究[J].临床精神医学杂志,2017,27(2):137-139.
[19] 杨和增,单菲,李敏智.围绝经期抑郁症患者文拉法辛治疗前后脑源性神经营养因子的变化[J].实用医学杂志,2018,34(3):457-459.
[20] 关书,熊伟,高云.脑源性神经营养因子与抑郁症[J].中国药理学通报,2018,34(2):153-156.
[21] 公维谦,陈玉社,赵燕,等.抑郁症合并2型糖尿病患者血浆BDNF水平与抑郁焦虑症状、TG的相关性[J].国际精神病学杂志,2017,44(3):398-400+403.
[22] 汪卫华,刘丽,李光耀,等.抑郁症患者血清瘦素和脑源性神经营养因子与疗效的相关性[J].临床精神医学杂志,2015,25(5):332-334.