抗抑郁治疗对2型糖尿病痛性神经病变的影响  

Effect of Antidepressive Treatment on Type 2 Diabetes Mellitus Patients with Painful Peripheral Neuropathy

作　　者：侯世芳[1] 周雁[2] 许贤豪[1] 

机构地区：[1]卫生部北京医院神经科,北京100730 [2]卫生部北京医院内分泌科,北京100730

出　　处：《中国神经免疫学和神经病学杂志》2008年第6期438-441,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的观察抗抑郁治疗对2型糖尿病痛性神经病变患者情绪障碍及疼痛的影响。方法将35例2型糖尿病痛性神经病变患者随机分为治疗组(20例)和对照组(15例)。收集患者一般临床资料和糖尿病控制情况,对照组常规给予降糖药、神经营养药、止痛药、改善微循环药物治疗。治疗组在此基础上加用抗抑郁药物西酞普兰20mg,1次/d,共14d。采用汉密尔顿抑郁量表(HAMD-17)评定患者治疗前后抑郁程度的变化,采用数字疼痛分级法(NPIS)评估疼痛改善情况,同时记录镇痛药物的等级,并检测糖化血红蛋白(HbA1c)以评价糖尿病控制情况。结果治疗前两组患者的临床一般情况、HbA1c及HAMD评分差异无统计学意义;治疗组治疗后第14天HAMD评分(17.69±7.45)显著低于治疗前(26.82±9.66)及同期对照组(24.71±8.92)(P<0.05),抑郁症状明显改善;治疗组第14天NPIS评分(2.5±0.8)显著低于同期对照组(4.8±1.1)和治疗前(6.0±2.2)(分别为P<0.05,P<0.01),镇痛药物的等级亦显著低于对照组(P<0.01)。结论抗抑郁治疗不仅可缓解患者的抑郁症状,还有益于疼痛的缓解。Objective To investigate the efficacy of antidepressive treatment to ameliorate 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 the control group and the treatment group. The general health state and the condition of DM of patients were recorded. 15 patients in the control group were given conventional drugs （including hypoglyeemic drugs, anodyne, neurotrophie drugs, antiplatelet drugs）, and the treatment group （20 patients） was treated both conventional drugs and antidepressant （citalopram, 20 mg, 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 and the hemoglobin Alc（HbA1C） was recorded. Results At day 14, the HAMD-17 scores （17.69 ± 7.45 ） in the treatment group were significantly decreased than those in the control group（24.71 ± 8.92）, P〈0.05;the NPIS scores （2.5±0.8） in the treatment group were also significantly decreased than those in the control group （4.8±1.1） , P〈0.05 . The level of anodyne given in the treatment group was also lower than in the control group （P〈0.01）. Conclusions After 14 days of antidepressant treatment, citalopram is effective not only to control depressive symptoms but also to enhance the relief of pain in type 2 DM patients with painful peripheral neuropathy.

关 键 词：糖尿病 神经病变 疼痛 抗抑郁药物 

分 类 号：R745[医药卫生—神经病学与精神病学] R587.1[医药卫生—临床医学]