阿米替林联合氟西汀治疗抑郁症的临床研究
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摘要
目的探讨盐酸阿米替林片联合盐酸氟西汀分散片治疗抑郁症的临床疗效。方法选取2016年1月—2017年6月重庆市精神卫生中心收治的抑郁症患者100例为研究对象,将所有患者依照随机信封法分为对照组和治疗组,每组各50例。对照组口服盐酸氟西汀分散片,初始剂量20 mg/次,1次/d,依照病情变化情况适当增加剂量,最大剂量60 mg/d。治疗组在对照组治疗的基础上口服盐酸阿米替林片,75 mg/d,2次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的甲状腺功能和汉密顿抑郁量表(HAMD)评分。结果治疗后,对照组和治疗组的总有效率分别为84.00%、98.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组三碘甲状原氨酸素(T3)、甲状腺素(T4)水平均显著降低,促甲状腺素(TSH)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组甲状腺功能指标水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组HAMD评分均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组HAMD评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论盐酸阿米替林片联合盐酸氟西汀分散片治疗抑郁症具有较好的临床疗效,可降低HAMD评分,改善甲状腺功能,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Amitriptyline Hydrochloride Tablets combined with Fluoxetine Hydrochloride Dispersible Tablets in treatment of depression. Methods Patients(100 cases) with depression in Chongqing Mental Health Center from January 2016 to June 2017 were randomly divided into control and treatment groups according to the random envelope method, and each group had 50 cases. Patients in the control group were po administered with Fluoxetine Hydrochloride Dispersible Tablets, starting dosage 20 mg/time, once daily, increased dosage according to the change of the condition, and the maximum dose was 60 mg/d. Patients in the treatment group were po administered with Amitriptyline Hydrochloride Tablets on the basis of the control group, 75 mg/d, twice daily. Patients in two groups were treated for three months. After treatment, the clinical efficacies were evaluated, and thyroid function and HAMD scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 98.00%, respectively, and there was significant difference between two groups(P < 0.05). After treatment, the levels of T3 and T4 in two groups were significantly decreased, but the levels of TSH in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the thyroid function leveles in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, HAMD scores in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the HAMD score in the treatment group was significantly lower than that in the control group, with significant difference between two groups(P < 0.05). Conclusion Amitriptyline combined with fluoxetine has clinical curative effect in treatment of depression, can reduce HAMD score, and improve thyroid function, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Amitriptyline Hydrochloride Tablets combined with Fluoxetine Hydrochloride Dispersible Tablets in treatment of depression. Methods Patients(100 cases) with depression in Chongqing Mental Health Center from January 2016 to June 2017 were randomly divided into control and treatment groups according to the random envelope method, and each group had 50 cases. Patients in the control group were po administered with Fluoxetine Hydrochloride Dispersible Tablets, starting dosage 20 mg/time, once daily, increased dosage according to the change of the condition, and the maximum dose was 60 mg/d. Patients in the treatment group were po administered with Amitriptyline Hydrochloride Tablets on the basis of the control group, 75 mg/d, twice daily. Patients in two groups were treated for three months. After treatment, the clinical efficacies were evaluated, and thyroid function and HAMD scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 98.00%, respectively, and there was significant difference between two groups(P < 0.05). After treatment, the levels of T3 and T4 in two groups were significantly decreased, but the levels of TSH in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the thyroid function leveles in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, HAMD scores in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the HAMD score in the treatment group was significantly lower than that in the control group, with significant difference between two groups(P < 0.05). Conclusion Amitriptyline combined with fluoxetine has clinical curative effect in treatment of depression, can reduce HAMD score, and improve thyroid function, which has a certain clinical application value.
引文
[1]刘建平.抑郁障碍患者人格特征与自杀风险研究[J].中国健康心理学杂志,2008,16(12):1390-1392.
[2]潘小平,李东秀.氟西汀对抑郁大鼠模型海马组织BDNF,Trk B表达的影响研究[J].现代预防医学,2015,42(1):128-130.
[3]王建刚.阿米替林治疗抑郁症68例疗效观察[J].中国医学工程,2013,21(10):63.
[4]刘平.ICD-10精神与行为障碍分类[M].北京:人民卫生出版社,1995:30-39.
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[6]汤毓华,张明园.汉密顿抑郁量表(HAMD)[J].上海精神医学,1984(2):61-64.
[7]刘同洲.选择性五羟色胺再摄取抑制剂(SSRIs)及其在精神科临床的应用[J].精神医学杂志,2003,16(4):251-253.
[8]李广权,周卫东,贺勇,等.抑郁症患者甲状腺功能变化的研究[J].国际检验医学杂志,2017,38(18):2556-2558.
[9]杨振宇,喻田.去甲肾上腺素对神经元、胶质细胞和小胶质细胞的功能调控作用及其机制研究进展[J].山东医药,2017,57(11):99-102.
[10]刘福坤,李立华,范长河.首发抑郁症患者抗抑郁治疗前后甲状腺功能的变化[J].广东医学,2013,34(3):371-374.
[2]潘小平,李东秀.氟西汀对抑郁大鼠模型海马组织BDNF,Trk B表达的影响研究[J].现代预防医学,2015,42(1):128-130.
[3]王建刚.阿米替林治疗抑郁症68例疗效观察[J].中国医学工程,2013,21(10):63.
[4]刘平.ICD-10精神与行为障碍分类[M].北京:人民卫生出版社,1995:30-39.
[5]孙传兴.临床疾病诊断依据治愈好转标准[M].第2版.北京:人民军医出版社,1998:222.
[6]汤毓华,张明园.汉密顿抑郁量表(HAMD)[J].上海精神医学,1984(2):61-64.
[7]刘同洲.选择性五羟色胺再摄取抑制剂(SSRIs)及其在精神科临床的应用[J].精神医学杂志,2003,16(4):251-253.
[8]李广权,周卫东,贺勇,等.抑郁症患者甲状腺功能变化的研究[J].国际检验医学杂志,2017,38(18):2556-2558.
[9]杨振宇,喻田.去甲肾上腺素对神经元、胶质细胞和小胶质细胞的功能调控作用及其机制研究进展[J].山东医药,2017,57(11):99-102.
[10]刘福坤,李立华,范长河.首发抑郁症患者抗抑郁治疗前后甲状腺功能的变化[J].广东医学,2013,34(3):371-374.