乳腺癌手术前伴焦虑抑郁情绪患者的抗抑郁药物治疗对照研究  

Efficacy of paroxetine in the treatment of depression and anxiety in patients with breast cancer undergoing surgery

作　　者：沈瑾[1] 周波[1] 吴宇洁[2] 朱荣申[2] 沈睿[1] 

机构地区：[1]上海市第十人民医院干部外科,200072 [2]上海市第十人民医院心理科

出　　处：《上海精神医学》2008年第6期357-359,共3页Shanghai Archives of Psychiatry

摘　　要：目的评估抗抑郁药物治疗乳腺癌改良根治手术前伴焦虑抑郁情绪患者的疗效。方法对2006年1月至2007年10月住院的37例乳腺癌患者在入院后三天内手术前进行汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估,将HAMA≥14及HAMD≥17的焦虑抑郁患者随机分为研究组(15例)和对照组(15例)。研究组采用改良根治手术+抗抑郁药物(帕罗西汀)治疗,对照组采用常规改良根治手术治疗。观察三周,比较两组术后情绪变化及创面愈合情况。结果与基线比,术后一周研究组HAMD减分大于对照组(4.2±1.5、2.7±1.1,F=0.8,P<0.05),差异有统计学意义;术后三周研究组HAMD和HAMA减分均大于对照组(HAMD:11.4±1.4、5.9±1.9,F=1.9,P<0.05;HAMA:9.1±2.2、4.5±1.4,F=5.2,P<0.05),差异均有统计学意义;与对照组比较,研究组创面愈合天数明显缩短(16.0±2.1、27.9±4.8,F=9.714,P<0.05),差异有统计学意义;术后三周,研究组患者焦虑缓解率(73.3%,11/15)高于对照组(40%,6/15),差异有统计学意义(2χ=3.4,P<0.05),抑郁情绪缓解率(86.7%,13/15)也高于对照组(40%,6/15,2χ=7.0,P<0.05)。结论对手术前伴抑郁焦虑的乳腺癌患者而言,手术联合抗抑郁药物治疗较单纯手术治疗疗效更好。Objective： To evaluate efficacy of paroxetine in the surgical treatment of breast cancer. Methods： All the breast cancer patients admitted from Jan. 2006 to Oct. 2007 were assessed according to HAMD and HAMA scores before surgery. Patietns with anxiety and depression（ HAMD≥ 17 and HAMA ≥ 14） were randomly divided into the study group （ n = 15 ） and the control group （ n = 15 ）. The study group was treated with modified radical surgery combined with antidepressant （paroxetine） and the control group was treated with modified radical surgery only. The efficacy was assessed with HAMD, HAMA and the wound healing period. Results： Compared with the control group, HAMD score of the study group significantly decreased 1 week after surgery （ P 〈 0. 05 ）, both HAMD and HAMA scores of the study group significantly decreased three weeks after surgery（P 〈 0.05）. The wound healing period in the study group was shorter than that of the control group [（16.0±2.1）d vs. （27.9 ±4.8）d,F=9.714,P 〈0.05） ], the remission rate for anxiety and depression were both higher than that of the control （73.3% vs. 40% , 86.7% vs. 40% , both P 〈 0.05）. Conclusion：Surgery combined with antidepressant is more effective in the treatment of depression and anxiety in patients with breast cancer.

关 键 词：乳腺癌 抑郁 焦虑 帕罗西汀 

分 类 号：R749.1[医药卫生—神经病学与精神病学]