抗抑郁治疗早期临床变化与疗效的相关分析  

Study on Early Clinical Changes and Efficacy of Antidepressant Treatment

作　　者：申景进[1] 张亚林[2] 曹玉萍[2] 陈向一[1] 

机构地区：[1]广东医学院附属深圳市南山医院精神卫生科,中国深圳518052 [2]中南大学附属湘雅二医院精神卫生研究所

出　　处：《中国健康心理学杂志》2012年第2期167-169,共3页China Journal of Health Psychology

摘　　要：目的探讨盐酸氟西汀抗抑郁治疗的临床症状早期变化与疗效的关系,为临床制定个体化治疗方案提供理论依据。方法采用盐酸氟西汀20mg/d对103例抑郁症患者治疗并完成随访6周,按照治疗6周末抑郁症状是否缓解分为缓解组和未缓解组。采用自行设计的"一般情况问卷"、"汉密尔顿抑郁量表"、"临床疗效总评定量表"进行评定。统计方法采用t检验和Pear-son相关分析。结果两组基础因子分比较,仅缓解组的阻滞因子基础分低于未缓解组,差异有显著性(t=-3.300,P<0.01)。治疗2周末,缓解组阻滞因子及睡眠障碍因子的减分率均显著高于未缓解组,差异具有显著性(t=2.880,2.602,P<0.05);两组总分、认识障碍因子、焦虑/躯体化因子及体重因子的减分率比较,差异无显著性(t=0.210,0.547,0.578,-0.309,P>0.05)。阻滞因子和睡眠障碍因子的2周末减分率与6周末总分减分率显著正相关(r=0.380,0.254,P<0.05)。结论治疗前患者的阻滞症状越轻,后期疗效越好。治疗2周末临床总严重程度评分愈小、阻滞症状及睡眠障碍的好转愈明显,后期疗效愈好。Objective To explore the relationship between clinical symptoms changes and efficacy of antidepressant treatment with fluoxetine,and provide a theoretical basis for making an individual treatment.Methods A total of 103 patients with depression were treated with fluoxetine（20mg/d） for 6 weeks.Patients were classed as remission group and non-remission group according to the response of endpoint with fluoxetine treatment.Subjects received standardized clinical assessments,including the demographic data,the Hamilton Depression Rating and the Clinical Global Impression Scale.Results To compare baseline scores of HAMD factors between two groups,only that of retardant factor of remitters was significantly lower than that of non-remitters（t=-3.300,P〈0.01）.At the second weekend,the reduction rate of retardant factor and sleep dysfunction factor were significantly higher in remission group than in non-remission group（t=2.880,2.602,P〈0.05）.As for the reduction rate,there were no significant differences between two groups in HAMD total score and HAMD factors of cognition,anxiety/somatization,avoirdupois（t=0.210,0.547,0.578,-0.309;P〈0.05）.Among all HAMD factors,only the reduction rate of retardant factor and sleep dysfunction factor had significantly positive cor relation with efficacy（r=0.380,0.254,P〈0.05）.Conclusion Those with lighter retardant and insomnia symptoms before treatment will have a well outcome.The reduction rate of retardant factor and sleep dysfunction factor are higher,outcome would be better.

关 键 词：抑郁症 症状 盐酸氟西汀 疗效 

分 类 号：R749.4[医药卫生—神经病学与精神病学]