氟西汀合并奥氮平治疗伴自杀观念抑郁症地临床效果观察.docVIP

氟西汀合并奥氮平治疗伴自杀观念抑郁症的临床效果观察 【摘要】目的：研究氟西汀辅助奥氮平治疗伴自杀观念抑郁症的有效性。方法：将112例具有抑郁类精神疾病诊断结果的患者随机分为两组：氟西汀对照组40例，予以氟西汀20 mg／d口服；奥氮平对照组40例，予以奥氮平15mg/d口服；氟西汀合并奥氮平实验组40例，除口服氟西汀外，另加奥氮平5～15mg／d口服，两组患者均住院治疗观察8周，比较两组临床疗效、Hamilton抑郁量表（HAMD）以及不良反应。结果：观察组总有效率85％（34/40）显著高于对照组52.5％（21/40），总分及减分率第1周差异有统计学意义（2=13.152，P=0.013），而且这种差异在每个访视期均存在，实验组在第l、2、4周末的有效性均较对照组高(P0.05或0.01)；两组治疗8周末有效率差异无统计学意义。结论:奥氮平合并氟西汀治疗抑郁症起效快，可提高疗效，效果比较显著，并能迅速改善失眠症状，对复发率几无影响。 【关键词】奥氮平；氟西汀；抑郁症 Abstract：objective: To study the secondary olanzapine Fluoxetine treatment effectiveness with depression, suicidal ideation. Methods: 120 patients with a diagnosis of mental illness of depression category were randomly divided into two groups: a control group of 40 patients fluoxetine be fluoxetine 20 mg / d orally; olanzapine group 40 cases, be olanzapine fluoxetine with olanzapine experimental group of 40 patients, with the exception of fluoxetine, another plus olanzapine 2.5 ~ 5.0mg / d orally, patients were hospitalized for observation eight weeks of treatment, comparative clinical efficacy, Hamilton depression amount table (HAMD) and adverse reactions. Results: The total effective rate of 85% (34/40) was significantly higher than 52.5% (21/40), the first week out, and reduction rate difference was statistically significant (2= 13.152, P = 0.013 ), and this difference was the presence of each visit, the experimental group at l, 2,4 weekend compared with the control group efficacy (P 0.05 or 0.01); after 8 weeks treatment, there was no efficient statistically significant. Conclusion：The combination of olanzapine and fluoxetine rapid onset of depression may improve the outcome, the effect is significant, and can quickly improve the insomnia symptoms, but almost no effect on the recurrence rate. 1 前言 1.1抑郁症的临床表现 抑郁症患者是指那些患有思维迟缓、意志活动减退、认知功能受到损害等一种或多种症状的人群，抑郁病的临床表现为：单次或多次反复的病情发作。一般医学上认为：抑郁症的发病主要与人体大脑内的5-羟色胺的功能低下有相当大的关联，但是至今为止，医学上并没有给抑郁症的真正病因以合理解释。可以肯定的是，抑郁病的发作是由社会环境、生理健康、心理健康等诸多要素综合结果造成的。其中，生物学方面主要涉及到神经、细胞以及基因遗传等因素；心理方面主要涉及到病人的内心的