舍曲林单用与合并不同剂量丁螺环酮治疗抑郁症患者的对照研究  

Comparison of treatment effect of sertraline single and combination with different doses of buspirone for major depression

作　　者：付佳林 汤臻[1] 朱峰[1] 刘期春 伏天 赵林[1] 

机构地区：[1]江苏省苏州市广济医院临床心理科,215008

出　　处：《临床精神医学杂志》2016年第2期105-108,共4页Journal of Clinical Psychiatry

摘　　要：目的:探讨不同剂量丁螺环酮对舍曲林抗抑郁的快速起效作用(ROAA)。方法:本研究是一项为期6周、不同剂量、随机、开放、对照的临床实验。90例抑郁症患者随机分为对照组30例(单一舍曲林)、舍曲林联合低剂量丁螺环酮(低剂量组)30例和舍曲林联合高剂量丁螺环酮(高剂量组)30例。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体印象表(CGI)等进行临床评估。观察治疗1周丁螺环酮是否使舍曲林的抗抑郁作用快速起效,并进一步评估第2、4、6周的临床差异。结果:以基线、治疗1周、治疗2周、治疗4周、治疗6周为观察点,3组被试无论HAMD总分还是HAMA总分,组间主效应不显著(P>0.05),时间主效应均显著(P均<0.01),组别×时间交互效应均显著(P均<0.05)。治疗1周,对照组5例起效(16.7%),低剂量组8例起效(26.7%),高剂量组14例(46.7%)起效,3组间差异有统计学意义(χ2=6.67,P=0.036),事后检验对照组与高剂量组差异有统计学意义(P<0.05)。3组间不良反应发生率差异无统计学意义(χ2=0.09,P>0.05)。结论:高剂量丁螺环酮对舍曲林的抗抑郁作用有快速起效的作用,安全有效。Objective： To explore the rapid response of different doses of buspirone in combination with sertraline on major depression. Method： This study was an open,controlled,randomized,clinical trial,lasting6 weeks. 90 patients were randomly assigned to controlled groups（ 30 cases,treated with sertraline）,low-dose group（ 30 cases,treated with low dose buspirone in combination with sertraline）,and high-dose group（ 30 cases,treated with high dose buspirone in combination with sertraline）. Clinical effects were evaluated with Hamilton depression scale（ HAMD）,Hamilton anxiety scale（ HAMA） and clinical general impression（ CGI）. The responses and treatment effects of different doses of buspirone in combination with sertraline were assessed at1 st,2nd,4th and 6th weekend. Results： The reapeated measure variance analysis result showed that there was not group main effect（ P 〉0. 05）. but time main effect（ P 〉0. 01） and group × time interaction effect（ P〈 0. 05） on HAMA and HAMD total score. After the first week of treatment,there was significant statistical difference（ χ2= 6. 67,P = 0. 036） on ROAA among the three groups,including 5 cases of rapid response in controlled group（ 16. 7%）,8 cases in low-dose group（ 26. 7%） and 14 cases in high-dose group（ 46. 7%）. There was statistical significance in response difference between controlled group and high-dose group（ P〈 0. 05）.There were no statistical differences of adverse reaction in three groups（ χ2= 0. 09,P 〉0. 05）. Conclusion：High dose of buspirone combined with sertraline has rapid clinical effect on major depression with little side effects.

关 键 词：抑郁症 舍曲林 丁螺环酮 快速起效 

分 类 号：R749.053[医药卫生—神经病学与精神病学]