文拉法辛与氟西汀治疗老年抑郁症对照研究.docVIP

文拉法辛与氟西汀治疗老年抑郁症对照研究 【摘要】 目的 探讨文拉法辛与氟西汀 治疗 老年抑郁症的疗效及安全性。 方法 将60例老年抑郁症患者随机分为两组各30例， 研究 组口服文拉法辛治疗，对照组口服氟西汀治疗，观察8 w。于治疗前及治疗1 w、2 w、4 w、6 w、8 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8w末，研究组总有效率93.3%，对照组为86.7%，两组总体疗效相当（χ2=0.185，P＞0.05）。汉密顿抑郁量表评分，研究组治疗1 w末起，对照组治疗2 w末起较治疗前有显著下降（P＜0.05或0.01），研究组治疗1 w、2 w末较对照组下降显著（P＜0.05），其他时点评分均无显著性差异（P＞0.05）。两组不良反应均轻微。 结论 文拉法辛治疗老年抑郁症的疗效与氟西汀相当，且起效较氟西汀快，安全性高，依从性好。 【关键词】 老年抑郁症；文拉法辛；氟西汀；临床疗效；安全性 　　A control study of venlafaxine vs fluoxetine in the treatment of elderly depression 　　【Abstract】 Objective To explore the efficacy and safety of venlafaxine and fluoxetine in the treatment of elderly patients with depression. Methods 60 patients were randomly divided into research group（n=30） took orally venlafaxine and control group（n=30） did fluoxetine for 8 weeks. Efficacies were assessed with the Hamilton Depression Scale（HAMD） and adverse reactions with the Treatment Emergent Symptom Scale（TESS）before treatment and at the ends of the 1st，2nd，4th，6th，and 8th week. Results After 8 week treatment，total effective rates were respectively 93.3% in the research and 86.7% in the control group，the total efficacies of both groups were equivalence（P0.05）. The HAMD scores lowered more significantly since the end of the 1st week in the research and of the 2nd in the control group compared with pretreatment（P0.05 or 0.01），did more significantly in the research than in the control group at the end of the 1st and 2nd week（P0.05），and there were no significant differences at other timepoints（P0.05）. Adverse reactions of both groups were mild. Conclusion Venlafaxine has therapeutic equivalence to fluoxetine，but takes effects quicker and has higher safety and better compliance in the treatment of elderly depression，and deserves to be extended and utilized clinically. 　　【Keywords】 Eelderlydepression；venlafaxine；fluoxetine；clinical efficacy；safety 　　文拉法辛是一种5羟色胺(5HT)、去甲肾上腺素(NE)神经递质双重再摄取抑制剂（SSRIs），属苯乙胺类，具有抗焦虑、抗抑郁双重作用的新型抗抑郁剂。其疗效已被国内外临床广泛验证［1～5］。氟西汀是SSRIs中的一种通过抑制突触前膜对