文拉法辛与氟西汀治疗儿童抑郁症对照研究.docVIP

文拉法辛与氟西汀治疗儿童抑郁症对照研究 作者：杜海霞 郭芳 郭素芹 李强 郭敬华 潘伟盟 【摘要】 　　目的 探讨文拉法辛 治疗 儿童抑郁症的临床疗效及安全性。 方法 将65例儿童抑郁症患者随机分为两组， 研究 组32例，口服文拉法辛治疗，对照组33例，口服氟西汀治疗，观察6 w。于治疗前及治疗1 w、2 w、4 w、6 w末采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。 结果 治疗后两组各时点汉密顿抑郁量表减分率均持续升高，治疗1 w、2 w末研究组减分率显著高于对照组（t=2.937，3.030，P＜0.01），4 w、6 w末差异无显著性（P＞0.05）。治疗6 w末，研究组总有效率为96.1%，对照组为90.9%，两组比较差异无显著性（χ2=0.619，P＞0.05）。两组不良反应均较轻微，主要为恶心、呕吐、口干、便秘等。 结论 文拉法辛与氟西汀治疗儿童抑郁症均有显著疗效，且不良反应轻微，但文拉法辛起效更快。 【关键词】 儿童；抑郁症；文拉法辛；氟西汀 　　【Abstract】 Objective To explore the clinical efficacy and safety of venlafaxine in treatment of child depression. Methods 65 child depression patients were randomly divided into research group（n=32）orally took venlafaxine and control group（n=33）fluoxetine for 6 weeks. The clinical efficacy was assessed with the Hamiltons Depression ScaleHAMD） and adverse effects with the Treatment Emergent Treatment Scale(TESS) at baseline and at the ends of the 1st,2nd,4th and 6th week treatment. Results After treatment, the scorereducing rates of the HAMD of both groups rised continiously, at the ends of the 1st and 2nd week those were very significantly higher in the research than in the control group(P0.01), and at the ends of the 4th and 6th week those were not significant(P0.05). at the end of the 6th week, total rates were 96.1% in the research and 90.9% in the control group respectively. Adverse effects of both groups were mild and mainly nausea,vomit,dry mouth, constipation and so on. Conclusion Both venlafaxine and fluoxetine have a significant efficacy and mild adverse effects, but the former takses effects faster. 　　【Keywords】 Children; depression; venlafaxine; fluoxetine 　　文拉法辛是一种新型的、具有双重作用的去甲肾上腺素（NE）和5HT再摄取抑制剂(SSRIs)，与氟西汀的作用机制不同，治疗儿童抑郁症的 文献 报道较少。为此，我们 应用 文拉法辛治疗儿童抑郁症与氟西汀进行了对照研究，以探讨其临床疗效及安全性，现将结果报告如下。 　　1 对象与方法 　　1.1 对象 选取2005年1月～2007年1月在我院住院的抑郁症患者为研究对象。入组标准：（1）符合《 中国 精神障碍分类与诊断标准》第3版（CCMD3）心境障碍抑郁发作诊断标准。（2）年龄≤16 a。（3）汉密顿抑郁量表（HAMD）总分≥18分。（4）排除严重躯体疾病，实验室检查严重异常者，精神发育迟滞和严重自杀倾向者。共入组65例，随机分为两组，研究组32例，男12例，女20例；年龄9 a～16 a，平均（14.72±1