氟西汀联合小剂量奥氮平治疗女性抑郁症对照探究.doc

氟西汀联合小剂量奥氮平治疗女性抑郁症对照探究【摘要】目的 探讨氟西汀联合小剂量奥氮平治疗女性抑郁症的临床疗效及安全性。方法 将62例女性抑郁症患者随机分为研究组31例，对照组31例,研究组口服氟西汀联合奥氮平治疗，对照组单用氟西汀治疗，观察8 w。于治疗前及治疗1 w、2 w、4 w、8 w末采用汉密顿焦虑量表、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8 w末，研究组显效率为80.65%，对照组为77.41%；研究组治疗1 w末和对照组治疗2 w末后各时段汉密顿焦虑量表、汉密顿抑郁量表评分较治疗前均有显著下降（P＜0.01），同期研究组均较对照组下降显著（P＜0.05或0.01）；两组不良反应均轻微，但发生率差异有显著性（P＜0.05）。 结论 氟西汀联合小剂量奥氮平治疗女性抑郁症疗效肯定，优于单用氟西汀治疗，且起效更快，不良反应轻微，安全性高，能显著提高患者的治疗依从性。 【关键词】抑郁症 氟西汀 奥氮平 汉密顿焦虑量表 汉密顿抑郁量表 副反应量表 中图分类号：R749.42文献标识码：B文章编号：1005-0515（2011）3-239-03 A controlled trial of fluoxetine combined with small-dose olanzapine in the treatment of female depression DUAN Zhirong （ChuXiong Second People,s Hospital, ChuXiong675000, China） 【Abstract】Objective To explore the clinical efficacy and safety of fluoxetine combined with small-dose olanzapine in the treatment of female patients with depression. Methods 62 female depression patients were randomly assigned to research group (n=31,fluoxetine plus olanzapine) and control group (n=31,fluoxetine alone) for 8 weeks.Curative effects were assessed with the Hanmilton Anxiety Scale(HAMA) and the Hanmilton Depression Scale (HAMD) and adverse reactions with the Treatment Emergent Symptom Scale(TESS) before treatment and at the ends of the 1st，2nd, 4th, 8th week treatment. Results At the end of the 8th week, effective rates were respectively 80.65% in the research and77.41% in the control group；compared with pre-treatment, the HAMA and HAMD score lowered more significantly in the research since the end of the 1st week and in the control group since the end of the 2nd week (P0.05)。 1.2 方法 1.2.1药物治疗 治疗组给予氟西汀（商品名：百优解）20~40mg/d,平均为(21.38±12. 67)mg/d, 联合小剂量奥氮平（商品名：再普乐）5~7.5mg/d治疗。对照组只给予氟西汀（商品名：百优解）20~40mg/d,平均为(22.56±11.18)mg/d治疗,两组用药剂量对比无差异(P0. 05)。 1.2.2 疗效评定 采用HAMD、HAMA于治疗前和治疗后第1、2、4、8周末评定其疗效。采用副反应量表（TESS）评定不良反应，并同时检查血常规、尿常规、心电图、肝功能。临床疗效以HAMD的减分率确定，减分率计算方法：减分率（%）=治疗前评分―治疗后评分/治疗前评分×100%，疗效分为四级,即痊愈(≥75% ),显著进步(≥50% ),进步(≥25% )及无效( 1.2.3 统计方法 所有数据采用SPSS11.5统计软件包处理，并