抗抑郁剂辅助治疗精神分裂症伴焦虑抑郁症状患者对照研究_0.docVIP

抗抑郁剂辅助治疗精神分裂症伴焦虑抑郁症状患者对照研究 作者：吴祥水 高镇松 李植荣 【关键词】 精神分裂症；抑郁；焦虑；抗抑郁药 　　【摘要】 目的 探讨联合小剂量抗抑郁剂 治疗 精神分裂症患者伴发焦虑抑郁症状的疗效及安全性。 方法 将146例精神分裂症伴发焦虑抑郁症状的患者随机分为两组， 研究 组76例， 应用 抗精神病药物联合小剂量抗抑郁治疗，对照组70例，单用抗精神病药物治疗；于治疗前及治疗4、8w末采用简明精神病量表、汉密顿抑郁量表、汉密顿焦虑量表、副作用量表评定临床疗效及不良反应。 结果 两组简明精神病量表、汉密顿抑郁量表、汉密顿焦虑量表总分治疗后均显著下降（P＜0.01），研究组治疗4末总有效率（88.2%）显著高于对照组（65.7%）（P＜0.01）；8w末两组总有效率相当（P0.05）；两组不良反应无显著性差异（P0.05）。 结论 联合小剂量抗抑郁剂对精神分裂症患者伴发焦虑抑郁症状有辅助治疗作用，不良反应轻微。 　　【关键词】 精神分裂症；抑郁；焦虑；抗抑郁药 　　A control study of antidepressants adjuvant in schizophrenics with anxious and depressive symptoms 　　【Abstract】 Objective To explore the efficacy and safety of smalldose antidepressants adjuvant in the treatment of schizophrenia with anxious and depressive symptoms. Methods 146 patients were randomly divided into two groups: research group(n=76) was treated with antipsychotics plus smalldose antidepressant(sertraline 50mg/d) and control group(n=70) with single antipsychotics. Clinical efficacies were assessed with the Brief Psychiatric Rating Scale (BPRS),the Hamilton Depression Scale(HAMD) and the Hamilton Anxiety Scale(HAMA), and side effects with the Treatment Emergent Symptom Scale (TESS) before treatment and at the ends of the 4th and 8th week. Results After treatment, the total scores of the BPRS,HAMD and HAMA of both two groups significantly decreased (P0.01). At the end of the 4th week, the total effective rate in the research group(88.2%) was significantly higher than that in the control group(65.7%), which was equivalent at the end of the 8th week (P0.05). The re was no significant difference side effects between the two groups (P0.05). Conclusion Combination of antipsychotics and smalldose anidepressant has adjunct effects on schizophrenics with anxious and depressive symptoms and side effects are milder. 　　【Keywords】 Schizophrenia；depression；anxiety；antidepressant 　　精神分裂症患者在病程的不同时期常伴有不同程度的抑郁症状［1］，住院精神分裂症患者恢复期有50.35%出现不同程度的抑郁［2］，而首次发病者抑郁症状发生率为63.0%［3］。为探讨抗精神病药物联合抗抑郁剂治疗精神分裂症后焦虑抑郁症状的疗效及安全性，我们进行了对照研究，现报告如下。