几种新型抗抑郁药治疗抑郁症首次发病患者的疗效比较  

Comparisons of new generation antidepressants in first-episode depression

作　　者：张雅红[1] 王化宁[1] 闫庆红[1] 王刚 谭庆荣[1] 

机构地区：[1]第四军医大学西京医院,西安710032 [2]北大安定医院

出　　处：《临床精神医学杂志》2012年第3期145-147,共3页Journal of Clinical Psychiatry

基　　金：国家"十一五"科技攻关资助项目(2007BAI17B05)

摘　　要：目的:评价和比较临床常用新型抗抑郁药的疗效及不良反应。方法:121例首发抑郁症患者随机分为西酞普兰组23例,艾司西酞普兰组22例,舍曲林组35例,帕罗西汀组41例,各组分别给予西酞普兰、艾司西酞普兰、舍曲林、帕罗西汀治疗,观察12周。于治疗前和治疗2、6、12周以汉密尔顿抑郁量表(HAMD-17)、16项抑郁症状快速调查表(QIDS-C16)、蒙哥马利抑郁评定量表(MADRS)和临床疗效总评量表(CGI)进行疗效评价以及治疗中出现的症状量表(TESS)评定药物不良反应。结果:共81例患者完成研究,其中76例达到临床治愈,4组间治愈率比较差异无统计学意义(χ2=0.90,P>0.05)。在治疗的各个阶段,4组间的HAMD-17、QIDS-C16、MADRS以及CGI评分差异均无统计学意义(F分别=1.02、0.18、0.93、0.63,P均>0.05)。TESS评分4组间差异无统计学意义(χ2=0.21,P>0.05)。结论:几种新型抗抑郁药对首发抑郁症患者疗效确切且相当,不良反应均较轻。Objective： To evaluate the efficacy and adverse effects of new generation antidepressants in first-episode depression. Method： 121 consenting adult outpatients with depressive disorder were brought into an assessor-blinded, parallel-group, randomised controlled trial and were randomly assigned to four groups ：cita- lopram （ n = 23 ）, escit-alopram （ n = 22 ）, sertraline （ n = 35 ） and paroxetine （ n = 41 ）. All patients were given at least one 12-week treatment with one kind of the four drugs. The efficacy measure scales included ：the Hamilton depression scale （ HAMD-17 ）, quick inventory of depressive symptomatology-elinician rated （ Q1DS-C16 ）,Montgomery-Asberg depression scale （MADRS）, and the clinical global impression scale （CGI）. Treatment e- mergent side-effect sca!e （TESS） were used to measure adverse effects at before and after treatment 2,6,12 weeks. Results：81 patients completed the trial and 76 patients got up to the standard of cure. There was no significant in all effectiveness measures（ X^2 = 0.90 ,P 〉 0.05 ）, including the changes from baseline in HAMD- 17 ,QIDS-C16 ,MADRS and CGI at twelve weeks（ respectively F = 1.02,0.18,0.93,0.63 ; all P 〉 0.05 ）, and there were no significant difference in adverse effects （ X^2 = 0.21, P 〉 0.05 ）. Conclusion ： New generation an- tidepressants have a similar efficacy in first-episode depression,adverse reactions are less.

关 键 词：抑郁症 西酞普兰 艾司西酞普兰 舍曲林 帕罗西汀 

分 类 号：R749.4[医药卫生—神经病学与精神病学]