重度抑郁症急性期奥氮平联合盐酸氟西汀治疗对患者生存质量的影响  

Influence of olanzapine-fluoxetine combination on quality of life in acute treatment of major depressive disorder

作　　者：瞿伟[1] 马红燕 谷珊珊[1] 罗菡[1] 唐倩影[1] 郭俊伟[1] 

机构地区：[1]第三军医大学西南医院临床心理科,重庆400038 [2]北京空政文工团卫生所,100039

出　　处：《重庆医学》2012年第27期2816-2818,共3页Chongqing medicine

摘　　要：目的探讨重度抑郁症急性期患者奥氮平联合盐酸氟西汀治疗对生存质量的影响。方法采用前瞻性、观察性设计,选择重度抑郁症处于急性治疗期患者103例,53例患者接受奥氮平联合盐酸氟西汀治疗(观察组),50例患者接受盐酸度洛西汀治疗(对照组),观察8周。观察指标为汉密尔顿抑郁量表24项(HAMD-24)及焦虑躯体化、睡眠障碍、迟缓、绝望感4个因子评分,临床总体严重程度评分(CGI-S),生存质量简表(WH0Q0L-BREF)总分及分测量项目评分。HAMD-24及因子评定分别于治疗前,治疗后1、2、4、8周末,WH0Q0L-BREF总分及分测项目评定时间为治疗前和治疗后8周。结果观察组患者HAMD-24评分在第1周显著低于对照组,4、8周末HMAD-24分测量中睡眠障碍因子评分明显低于对照组(P<0.05)。在治疗8周结束时,观察组患者生理领域评分明显高于对照组(P<0.05)。结论重度抑郁症急性期患者采用奥氮平联合盐酸氟西汀治疗,在改善患者睡眠及生存质量中生理状况比单用盐酸度洛西汀更具优势。Objective To explore the influence of olanzapine-fluoxetine combination on the quality of life in the acute treatment of major depressive disorders. Methods By the randomized prospective and observational design,the patients with major depressive disorders in the acute treatment were selected. 53 cases received olanzapine-fluoxetine combination treatraent（OFC group） and other 50 cases were given the treatment of duloxetine hydrochloride（control group）. Two groups were observed for 8 weeks. The observed indicators were the Hamilton Depression Rating Scale for Depression （ HAMD-24）, 4-factor scores （slow, sleep disorders, anxiety/somatization, hopelessness）, the Clinical Global Impression-Severity of Iillness（CGI-S）, WHO quality of life scale（WHO- QOL-BREF） and sub-item measurements. The HAMD-24 and four factor scores were assessed before treatment and at 1,2,4,8 weeks after treatment,and the WHOQOL-BREF score and sub-item measurements were assessed before treatment and in 8 weeks after treatment. Results The HAMD-24 scores at 1 week in the OFC group were significantly lower than those in the control group. The sleep factor scores at the end of 4,8 weeks in the OFC group were significantly lower than those in the control group. At the end of 8-week treatment,the scores of the physiological field in the OFC group were significantly lower than those in the control group. Conclusion In the acute treatment period using olanzapine-fluoxetine combination for treating severe depression,the depressive symptoms could be improved faster and taking effects is within a week,which is superior to single duloxetine hydrochloride in improving the physiological conditions of sleep and the quality of life.

关 键 词：抑郁症 生活质量 氟西汀 奥氮平 

分 类 号：R749.4[医药卫生—神经病学与精神病学]