文拉法辛联合利培酮治疗精神病性抑郁症对照研究.DOCVIP

临床医学论文-文拉法辛联合利培酮治疗精神病性抑郁症对照研究 ?????????????????? 作者：曹红军 宋新勤 张红梅 李德重 罗红霞 李莹 范凤兰 【摘要】? 目的 研究文拉法辛联合利培酮治疗精神病性抑郁症的临床疗效及安全性。 方法 将80例精神病性抑郁症患者随机分为两组各40例，两组均口服利培酮治疗，研究组联合文拉法辛治疗，对照组联合阿米替林治疗，观察6 w。于治疗前及治疗第1 w、2 w、4 w、6 w末采用汉密顿抑郁量表、简明精神病量表、临床疗效总评量表、副反应量表评定临床疗效及不良反应。 结果 治疗6 w末抑郁症状研究组显效率为78%，对照组为75%；精神病性症状研究组显效率为80%，对照组为83%，两组总体疗效相当（P＞0.05）。汉密顿抑郁量表、简明精神病量表总分及临床疗效总评量表评分两组治疗1 w末起均较治疗前有显著下降（P＜0.01）；但研究组治疗2 w末汉密顿抑郁量表评分及4 w末简明精神病量表、临床疗效总评量表评分均较对照组下降显著（P＜0.05）。副反应量表评分研究组治疗1 w、2 w、4 w、6 w末均显著低于对照组（P均＜0.01），研究组静坐不能、嗜睡、心电图改变、震颤不良反应发生率均显著低于对照组（P＜0.01～0.05）。 结论 两组总体临床疗效相当，但研究组起效更快、安全性更高、依从性更好。 【关键词】? 精神病性抑郁症；文拉法辛；阿米替林；利培酮? ??? 【Abstract】 Objective? To study the clinical efficacy and safety of venlafaxine combined with risperidone in the treatment of psychotic depression. Methods? 80 patients with psychotic depression were randomly divided into research group（n=40） taking orally risperidone combined with velafaxine and control group（n=40） risperidone with amitriptyline for 6 weeks. Clinical efficacy was assessed with the Hamilton Depression Scale（HAMD），the Brief Psychiatric Rating Scale（BPRS） and Clinical Global Impression（CGI） and adverse effect with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 1st，2nd，4th and 6th week treatment. Results? At the end of the 6th week，excellence rates were respectively 78% in the research group and 75% in the control；excellence rates of psychotic symptoms were 80% in the research and 83% in the control respectively，total efficacies of the 2 groups equivalent（P0.05）.Since the end of the 1st week，total scores of the HAMD，BPRS and CGI lowered significantly compared with pretreatment for both groups（P0.01）；the HAMD score at the end of the 2nd week and the BPRS and CGI scores at the end of the 4th week lowered more significantly in the research than in the control（P0.05）. All timepoint TESS scores（all P0.01） and incidences of such adverse effects as akathisia，drowsiness，ECG changes and tremor（P0.01～0.05） were significantly low