文拉法辛与阿米替林治疗抑郁症对照研究.docVIP

文拉法辛与阿米替林治疗抑郁症对照研究 【摘要】 目的 评价文拉法辛 治疗 抑郁症的疗效及安全性。 方法 将68例抑郁症患者随机分为两组各34例， 研究 组口服文拉法辛治疗，对照组口服阿米替林治疗，观察8 w。于治疗前及治疗1 w、2 w、4 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 研究组显效率76.5%，有效率91.2%；对照组分别为73.5%，88.2%。两组治疗1 w末起汉密顿抑郁量表评分均较治疗前有极显著性下降（P均＜0.01），并随治疗时间的延续呈持续性下降；治疗2 w、4 w末研究组较对照组下降显著（P＜0.05），8 w末无显著性差异（P＞0.05）。研究组不良反应发生率37.8%，对照组为54.7%，两组不良反应程度均轻微，经对症处理后症状可缓解。 结论 文拉法辛治疗抑郁症疗效与阿米替林相当，但文拉法辛起效快，安全性高，依从性好。 【关键词】 抑郁症；文拉法辛；阿米替林 　　【Abstract】 Objective To evaluate the efficacy and safety of venlafaxine in the treatment of depression．Methods 68 depression patients were randomly assigned to venlafaxine group(n=34) and amitriptyline group(n=34) for 8 weeks. Clinical efficacies were assessed with Hamilton Depression Rating Scale(HAMD) and adverse effects with the Treatment Emergent Symptoms Scale (TESS) before teratment and at the ends of the 1st,2nd,4th and 8th week treatment． Results Excellece and effectiveness rates were respectively 76.35% and 91.2％ in the research group and 73.5％ and 88.2％ in the control group. Since the end of the 1st week, The HAMD scores of both groups lowered very significantly compared with pretreatment(both P0.01) and did continiously following time of therapy lasting; at the ends of the 2nd and 4th week, those did more significantly in the research than in the control group(P0.05). Incidences of adverse reactions were respectively 37.8% in the research and 54.7% in the control group, thEir extents were mild and could relieve and disappear after symptomatic treatment. Conclusion Venlafaxine has equivalent efficacy to amitriptyline,higher safety and better compliance, and takes fefects faster in the treament of depression. 　　【Keywords】 Depression; venlafaxine; amitriptyline 　　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羟色胺再摄取抑制剂（SSRIs），5HT能加速NE引起的β受体向下调节，而β受体向下调节与抗抑郁起效相关联，具有快速抗抑郁效应［1，2］。为探讨文拉法辛治疗抑郁症的临床疗效及安全性，我们与阿替米林进行了对照研究，现报告如下。 　　1 对象与方法 　　1.1 对象 选取2005年10月～2006年12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）抑郁症诊断标准。（2）年龄18 a～60 a。（3）汉密顿抑郁量表（HAMD）17项总分