小剂量奥氮平联合文拉法辛对重度抑郁患者急性期治疗临床效果的观察  

Observation on the clinical effect of small dose of olanzapine combined with venlafaxine in the acute phase treatment on patients with severe depression

作　　者：肖长久[1] 陈海珠[1] 程国强[1] 谭常赞[1] 刘芳[2] XIAO Changjiu;CHEN Haizhu;CHENG Guoqiang(No.3 Renmin Hospital of Zhaoqing, Zhaoqing 526060, Chin)

机构地区：[1]肇庆市第三人民医院,肇庆526060 [2]肇庆市第一人民医院

出　　处：《国际精神病学杂志》2018年第2期278-281,共4页Journal Of International Psychiatry

摘　　要：目的探讨小剂量奥氮平联合文拉法辛对重度抑郁患者急性期治疗的临床效果。方法选取2013年3月~2015年10月我院门诊明确诊断为重度抑郁症的患者80例。按随机数字表法平均分为两组:实验组与对照组。对照组予以盐酸文拉法辛缓释片150mg早餐后服用,同时予以淀粉制作的安慰剂5mg晚餐后服用;实验组予以盐酸文拉法辛缓释片150mg早餐后服用,同时予以奥氮平5mg晚餐后服用。两组患者在服药前、服药4w后均予以评估蒙哥马利抑郁量表(MADRS)、焦虑自评量表(SAS)。服药4周后均予以评估药物副反应量表(TESS)。结果两组患者在服药前MADRS、SAS评分对比,组间差异不明显义(P>0.05);服药4周后,两组患者MADRS、SAS评分较服药前评分均显著降低(P<0.05);且实验组的MADRS、SAS评分明显低于对照组,(P<0.05);服药4周后两组的TESS评分对比,组间差异无统计学意义(P>0.05)。结论小剂量奥氮平联合文拉法辛在急性治疗期治疗重度抑郁症,比单用文拉法辛可以取得更好的临床疗效,更好更快的缓解患者的抑郁焦虑情绪,减低自杀风险,且具有较好的安全性。Objective To discuss the effect of small dose of olanzapine combined with venlafaxine in the acute phase treatment on patients with severe depression. Method 80 cases of patients with severe depression were selected from March 2013 to October 2015 in our hospital. According to the method of random number table, all the patients were divided into two groups averagely： the control group and the experimental group. The control group were given venlafaxine hydrochloride sustained-release capsules 150mg after breakfast and placebo （ starch ） 5rag after supper. Meanwhile, the experimental group were received venlafaxine hydrochloride sustained-release capsules 150mg after breakfast and olanzapine 5mg after supper. The scores of MADRS, SAS were compared between the two groups of patients before medical treatment and 4 weeks after treatment. Also, the scores of TESS were only compared between the two groups 4 weeks after medical therapy. Results There is no statistical difference between the two groups in MADRS and SAS before medical treatment （P〉0.05） . After 4 weeks medical therapy, the scores of MADRS and SAS all decreased compared with that before medical therapy in both groups, and the differences had statistical significances （P〈 0.05 ） . Meanwhile, the scores of MADRS and SAS of the experimental group were significantly lower than that of the control group, and the difference had statistical significance （P 〈 0.05 ） . There is no statistical difference between the two groups in the TESS 4 weeks after medical therapy （ P〉 0.05 ） . Conclusion There is a better clinical effect of small dose of olanzapine combined with venlafaxine in the acute phase treatment on patients with severe depression than venlafaxine only. The combination of two kinds of medicine can relieve the patients＇ depression and anxiety mood much faster so that it can decrease the risk of suicide. Also, it＇ s as safe as venlafaxine only.

关 键 词：抑郁症 奥氮平 文拉法辛 急性期 治疗 

分 类 号：R749.053[医药卫生—神经病学与精神病学]