心理干预联合文拉法辛、利培酮治疗难治性抑郁症的疗效及对生活质量的影响  

Effect of psychological intervention combined with venlafaxine and risperidone in the treatment of refractory depression and its influence on the quality of life

作　　者：张卫华[1] 陈兴阳[1] 齐文耀 汪晓静[1] Zhang Weihua, Chen Xingyang, Qi Wenyao, Wang Xiaojing.(1 The First Female Ward,the Second People＇s Hospital of Taizhou , Taizhou , Zhejiang 317200 , China ;2Psychosomatic Ward,the Second People＇s Hospital of Taizhou, Taizhou ,Zhejiang 317200,Chin)

机构地区：[1]台州市第二人民医院女一病区,浙江省台州317200 [2]台州市第二人民医院心身科病区,浙江省台州317200

出　　处：《中国基层医药》2018年第6期720-724,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨心理干预联合文拉法辛、利培酮治疗难治性抑郁症的疗效及对患者生活质量的影响。方法选择难治性抑郁症患者97例，采用随机数字表法分为观察组50例和对照组47例，对照组给予文拉法辛、利培酮治疗，观察组在对照组基础上使用心理干预。记录两组治疗前、治疗第4周、治疗第8周、治疗第12周后汉密尔顿抑郁量表（HAMD）评分，于治疗12周后进行疗效评价，采用副反应量表（TESS）评分进行副反应评价，并比较患者治疗前、治疗后12周生活质量（WHOQOL-100）评分。结果治疗前两组HAMD评分差异无统计学意义（t=0．307，P〉0．05），治疗4周、8周、12周两组HAMD评分均较治疗前显著降低（t=5．743、17．756、27．288、4．595、15．801、23．247，均P〈0．05），且治疗8周、12周观察组HAMD评分均显著低于对照组（t=0．887、3．717、5．854，均P〈0．05）；治疗12周后，观察组总有效率显著高于对照组（90．00％比74．47％，Х^2=4．043，P〈0．05）；两组不良反应发生率差异无统计学意义（26．00％比25．52％，0=0．003，P〉0．05）；治疗前两组WHOQOL-100评分差异均无统计学意义（t=0．597、0．497、0．378、0．923、0．136，均P〉0．05），治疗后两组WHOQOL-100评分均显著高于治疗前（t=11．668、8．701、6．857、7．053、2．247、4．815、4．639、2．999、4．117、2．011，均P〈0．05），且治疗后观察组心理、生理、独立性以及社会关系领域评分均显著高于对照组（t=5．618、3．295、4．335、3．603，均P〈0．05）。结论心理干预联合文拉法辛、利培酮治疗难治性抑郁症可显著提高临床疗效，并提高患者生活质量，值得临床推广运用。Objective To investigate the effect of psychological intervention combined with venlafaxine and risperidone in the treatment of refractory depression and its influence on the quality of life. Methods 97 patients with refractory depression were selected. According to the random number table, they were divided into the observation group （50 cases ） and the control group （47 cases ）. The control group was given venlafaxine combined with risperidone treatment, the observation group received psychological intervention on basis of the control group. The Hamilton depression scale（HAMD） of patients in the two groups before treatment,4,8 and 12 weeks after treatment were recorded. The curative effect after 12 weeks of treatment was evaluated, the adverse reaction was evaluated by the side effects scale（TESS）, and the quality of life （WHOQOL-100） of the two groups before treatment, 12 weeks after treatment were compared. Results The HAMD score of the two groups had no statistically significant difference before treatment（ t = 0.307,P 〉 0.05 ）. After treatment for 4,8,12 weeks, the HAMD scores of the two groups were significantly lower than before treatment（ t = 5. 743,17. 756,27. 288,4. 595,15. 801,23. 247, all P 〈 0.05 ）, and the HAMD scores in the observation group after treatment for 8 weeks and 12 weeks were significantly lower than those in the control group （t = 0. 887,3.717,5. 854, all P 〈 0.05 ）. After 12 weeks of treatment, the total effective rate of the observation group was significantly higher than that of the control group （ 90.00% vs. 74.47% , Х^2= 4. 043, P 〈 0.05 ）. There was no statistically significant difference in incidence rate of adverse reactions between the two groups （26. 00% vs. 25.52%, Х^2= 0. 003, P 〉 0.05 ）. The WHOQOL-100 scores of the two groups had no statistically significant differences before treatment（ t = 0. 597,0. 497,0. 378,0. 923,0. 136, all P 〉 0.05 ）. The WHOQOL-100 scores of the two groups after treatment were significantl

关 键 词：抑郁症 心理疗法 文拉法辛 利培酮 生活质量 

分 类 号：R749.4[医药卫生—神经病学与精神病学]