喹硫平与奥氮平对帕罗西汀治疗抑郁症伴焦虑障碍患者增效作用的比较  

Contrast study of synergistic effect of Quetiapine and Olanzapine on patients with depression combined with anxiety disorder treated with Paroxetine

作　　者：王学燕[1] 周玉珍[2] 杨红梅[1] 孙克峰[1] 梁家騋[1] 

机构地区：[1]济南市精神卫生中心,山东济南250032 [2]济宁市精神病防治院

出　　处：《中国民康医学》2015年第6期29-30,32,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较帕罗西汀合并喹硫平和合并奥氮平治疗抑郁症伴焦虑障碍患者的疗效和安全性。方法:将60例抑郁症伴焦虑障碍的患者随机分成帕罗西汀合并喹硫平组(合并喹硫平组)和帕罗西汀合并奥氮平组(合并奥氮平组),各30例。共治疗8周,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及副反应量表(TESS)评定两组患者的疗效和不良反应。结果:治疗后1周开始,两组患者的HAMD和HAMA评分较治疗前下降均有统计学意义(P<0.01)。同期两组患者间比较差异无统计学意义(P>0.05)。两组患者显效率无明显差异(P>0.05)。对于不良反应(如恶心、口干、便秘、心动过速、食欲和体质量增加等),合并奥氮平组患者除了食欲和体质量增加发生率高于合并喹硫平组,差异有统计学意义(P<0.05)外,余项无明显差异。结论:帕罗西汀合并喹硫平和合并奥氮平治疗抑郁症伴焦虑障碍疗效相当,起效快,不良反应少,依从性好,均为较好增效策略。肥胖者合并喹硫平治疗更安全。Objective: To compare efficacy and safety of Paroxetine combined with Quetiapine or Olanzapine in treatment of patients with depression combined with anxiety disorder. Methods:60 patients suffering from depression with anxiety disorder were randomly divided into Paroxetine combined with Quetiapine group (n=30, combined Quetiapine group) and Paroxetine combined with Olanzapine group ( n=30, combined Olanzapine group). The treatment continued for eight weeks. Hamilton depression scale ( HAMD) , Hamilton anxiety scale ( HAMA) , and treatment emergent symptom scale ( TESS) were used to evaluate efficacy and ad-verse reactions. Results:One week after the treatment, the scores of HAMD and HAMA of the two groups decreased compared with those before the treatment, the differences of the same group were significant (P<0. 01); however, the differences between the two groups were insignificant (P>0. 05). No big difference between the two groups in the obvious effective rate (P>0. 05). For the ad-verse reactions ( nausea, dry mouth, constipation, tachycardia, loss of appetite and weight gain):the occurrence rates of increased ap-petite and body mass gain of combined Olanzapine group were higher than those of combined Quetiapine group, and the differences had statistical significance (P<0. 05);however, the other items had no obvious differences. Conclusions:For the patients with depression combined with anxiety disorder, Paroxetine combined with Quetiapine or Olanzapine both has a faster effect, fewer adverse reactions, and good compliance;so the two ways are all rather good synergistic strategies. For the obese, the treatment of combination of Quetiap-ine is safer.

关 键 词：喹硫平 奥氮平 帕罗西汀 抑郁症 焦虑障碍 

分 类 号：R749.42[医药卫生—神经病学与精神病学]