无抽搐电休克联合文拉法辛治疗抑郁症伴自杀未遂患者的疗效  

Venlafaxine Combined Modified Electroconvulsive Therapy in the Treatment of Depressive Patients with Attempted Suicide

作　　者：王小泉[1] 王祖森[1] 沈蒶华 蔡昌群[1] 宋传福[1] 梁可美[1] WANG Xiaoquan ,WANG Zusen ,SHEN Yuhua ,et al(The 4th People＇s Hospital of Wuhu City ,Wuhu 241002,Chin)

机构地区：[1]安徽省芜湖市第四人民医院

出　　处：《中国健康心理学杂志》2018年第4期485-488,共4页China Journal of Health Psychology

基　　金：国家高技术研究发展计划(编号:2014AA022304);安徽省神经精神疾病与心理健康协同创新中心2016年开放性课题(编号:NDMHCI-16-08);芜湖市科技惠民项目(编号:2012hm36)

摘　　要：目的：探讨文拉法辛联合无抽搐电休克（MECT）对抑郁症的疗效及对自杀的影响,为快速改善抑郁症伴自杀未遂患者的症状提供研究依据。方法：选取在芜湖市第四人民医院住院的伴自杀未遂的抑郁症患者84例,随机分为研究组41例（MECT联合文拉法辛治疗）和对照组43例（文拉法辛治疗）,两组文拉法辛剂量范围125-225mg/d,均作4周的持续治疗观察。于入组前及入组后1、2、4周末分别采用汉密尔顿抑郁量表17项版（HAMD-17）及自杀意念自评量表（SIOSS）进行评定。结果：研究组39例完成治疗,对照组43例完成治疗。研究组在治疗后1、2、4周末的HAMD-17总评分低于对照组,差异有统计学意义（P〈0.05）。治疗4周后,研究组和对照组有效率比较差异有统计学意义（χ^2=5.190,P=0.023）。治疗前两组SIOSS评分比较差异无统计学意义;在治疗的第1、2、4周末,研究组的SIOSS评分均低于对照组,差异有统计学意义（t=-4.229,-5.342,-4.339;P=0.000）;在治疗4周末,研究组及对照组的SIOSS评分均低于治疗前（t=18.520,18.112;P=0.000）结论：与单用文拉法辛相比,文拉法辛联合MECT能更快速有效的改善伴有自杀未遂的抑郁症患者的临床症状。Objective：To explore the efficacy of venlafaxine with modified electric convulsive therapy（MECT）in the treatment of depressive disorder patients with attempted suicide.Methods：A total of 84 patients with suicide-attempted depression were randomly divided into research group（n=41,MECT combined with venlafaxine）and control group（n=43,venfaxine）.Two groups with venlafaxine were ranged in 125 mg to 225 mg/day in the 4-week study.The clinical efficacy were assessed by Hamilton Depression Scale 17-item（HAMD-17）and suicidal idea self rating scale（SIOSS）were assessed before treatment and at the end of the week 1,2,4.Results：There were 39 patients in research group and 43 patients in control group who completed the 4 weeks＇ study.HAMD scores of the research group at the end of the week of 1,2,4 after treatment were significantly lower than that of the control group,the difference was statistically significant（P〈0.05）.The response rate had asignificant difference between two groups at the end of the 4-week treatment.（χ^2=5.190,P〈0.05）.There was no significant difference in SIOSS rating between the two groups before treatment（P〉0.05）.At the end of the week of 1,2,4 after treatment,SIOSS scores in the study group were significantly lower than that of the control group（t=-4.229,-5.342,-4.339;P〈0.001）.In the treatment of 4 the weekend,the SIOSS score in two groups were both obviously lower than that before treatment（t=18.520,18.112;P〈0.001）.Conclusion：Compared with venlafaxine,venlafaxine combined MECT is more effective and takes effect more quickly in the treatment of suicide-attempted depression.

关 键 词：抑郁症 无抽搐电休克 自杀未遂 文拉法率 

分 类 号：R749.05[医药卫生—神经病学与精神病学]