文拉法辛联合治疗方案对难治性抑郁症疗效的随机对照研究  

A randomized controlled clinical trial of the combination of venlafaxine for treatment-resistant depression

作　　者：高代林[1] 徐佳军[1] 毕建强[1] 舒建民[1] 张郭莺[1] 杨彦春[1] 孙学礼[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041

出　　处：《中华精神科杂志》2009年第3期146-148,共3页Chinese Journal of Psychiatry

基　　金：国家“十五”科技攻关资助项目（2004BA720A21-01）

摘　　要：目的比较文拉法辛联合不同治疗方案对难治性抑郁症疗效。方法采用数字随机法将69例难治性抑郁症患者分为文拉法辛（75～375mg／d）合并碳酸锂（500—1000mg／d）组、文拉法辛合并奥氮平（5—10mg／d）组，文拉法辛合并认知行为治疗组，每组均为23例，观察疗程均为6周。主要疗效指标为汉密尔顿抑郁量表（17项，HAMD）减分率。HAMD减分率采用t检验进行两两比较。结果治疗第6周末，文拉法辛合并认知行为组HAMD减分率[（61±5）％]与合并碳酸锂组[（54±7）％]的差异有统计学意义（t=8．90，P〈0．05）；与合并奥氮平组[（47±6）％]的差异亦有统计学意义（t=3．46，P〈0．05）。合并碳酸锂组HAMD减分率与合并奥氮平组的差异无统计学意义（t=0．00，P〉0．05）。结论文拉法辛联合认知行为治疗难治性抑郁症的疗效优于文拉法辛联合碳酸锂或照氛平．Objective To compare the efficacy of venlafaxine combination of cognitive behavior therapy or lithium or olanzapine for treatment-resistant depression. Method A prospective stratified randomized controlled clinical trial were adopted to the patients with treatment-resistant depression. 69 cases were divided into three groups with random number table, each group including 23 cases. One group was with venlafaxine combination of cognitive behavior therapy, others with combination of lithium, or olanzapine, for 6 weeks to observe the efficacy. The major indexes for therapeutic effects was Hamilton Depression Scale （HAMD） reducing score rate. Results The differences were significant in HAMD reducing score rate between the group with combination of cognitive behavior therapy[ （61 ± 5 ）% ] and the group with combination of lithium [ （ 54 ± 7 ） % ] （ t = 8.90, P 〈 0.05 ）, or olanzapine [ （ 47 ± 6 ） % ] （ t = 3.46,P 〈 0.05 ）, with no significant difference is between the group with combination of lithium and the group with combination of olanzapine. Conclusion The total efficacy of venlafaxine combination of cognitive behavior therapy is superior to venlafaxine combination of lithium or olanzapine for treatmet-resistant depression.

关 键 词：抑郁症 认知疗法 行为疗法 文拉法辛 

分 类 号：R686[医药卫生—骨科学]