抗抑郁治疗对2型糖尿病痛性神经病变的影响.doc

西酞普兰治疗对2型糖尿病痛性神经病变的疗效 周雁2，许贤豪1 (卫生部北京医院，1. 神经科，2. 内分泌科，北京100730) 摘 要： 目的 观察西酞普兰治疗对2型糖尿病痛性神经病变患者情绪障碍及疼痛的疗效。方法 将35例2型糖尿病痛性神经病变患者（正在接受常规降糖药、神经营养药、止痛药、改善微循环药物治疗的患者）采用随机双盲法分为治疗组(20例)和对照组(15例)。收集患者的一般资料和糖尿病控制情况，对照组继续原有治疗，治疗组在此基础上加用抗抑郁药物，西酞普兰20 mg/d，观察2周。以汉密尔顿抑郁量表(HAMD-17)评定抗抑郁疗效，用数字疼痛分级法(NPIS)评估疼痛的改善情况，同时记录镇痛药物的等级。结果 治疗前两组患者的一般情况及HAMD平均总分的差异无统计学意义，治疗后第14天的HAMD评分治疗组(17.69±7.45)显著低于对照组(24.71±8.92)(P0.05)，抑郁症状明显改善；治疗组第14天的NPIS评分(2.5±0.8)显著低于对照组(4.8±1.1)(P0.05)，疼痛缓解情况优于对照组(P0.01)；镇痛药物的等级要低于对照组(P0.01)。结论 西酞普兰治疗不仅可以缓解患者的抑郁症状，还加强对疼痛的缓解。 关键词：糖尿病; 神经病变; 疼痛; 西酞普兰；抗抑郁药 Effect of citalopram treatment on type 2 diabetes mellitus patients with painful peripheral neuropathy Hou shifang,Zhou yan, Xu xianhao. （Beijing Hospital, Ministry of Health,1. Department of Neurology,2. Department of Endocrinology, Beijing 100730） Abstract： Objective To investigate the efficacy of antidepressive treatment to control depressive symptoms and pain symptoms in type 2 diabetes mellitus (DM) patients with painful peripheral neuropathy. Methods 35 patients were enrolled in this trail, and were randomly divided into control group and treatment group. The general health state and the condition of DM of patients were recorded. Control group (15patients) was given conventional drugs(including hypoglycemic drugs, anodyne, neurotrophy drugs, antiplatelet drugs), and treatment group (20 patients) was given both conventional drugs and antidepressant (citalopram, 20mg, Qd, 14 days). Hamilton Depression Rating Scale for Depression(HAMD-17) was used to assess depressive symptoms, and numeric pain intensity scale (NPIS) was used to assess pain symptoms. At the same time, level of anodyne was recorded. Results At day 14, the HAMD-17 score(17.69±7.45) in treatment group were significantly decreased than control group(24.71±8.92), P0.05；the NPIS scores (2.5±0.8) in treatment group were also significantly decreased than control group ( 4.8±1.1), P0.05 . The level of anodyne in treatment group was also lower than cont