氟西汀与奥氮平对改善脑梗死后抑郁状态的效果比较  

Comparison study of the effects of fluoxetine combined with olanzapine on depressive state after cerebral infarction

作　　者：王彦[1] 李艳琴[1] 王洋[1] 李斌[1] WANG Yan;LI Yanqin;WANG Yang(Department of Neurology,People’s Hospital of Tangshan City,Hebei,Tangshan 063001,China)

机构地区：[1]河北省唐山市人民医院神经内科,063001

出　　处：《河北医药》2018年第9期1389-1391,共3页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划项目(编号:201204600)

摘　　要：目的探讨氟西汀与奥氮平对脑梗死后抑郁状态的改善程度,分析临床治疗效果。方法选择收治的脑梗死后抑郁患者84例,按照随机原则平均分为2组,其中对照组采用氟西汀治疗,观察组采用氟西汀联合奥氮平治疗,对比2组患者治疗2周、4周、6周及8周时的汉密尔顿抑郁量表(HMMD)评分、汉密尔顿焦虑量表(HMMA)评分,比较治疗8周时患者的神经功能缺损评分、日常生活能力量表评分以及临床疗效和不良反应发生率。结果治疗后2周、4周、6周及8周时2组患者的HMMD评分、HMMA评分均有明显下降(P<0.05),并且随着治疗时间的延长,评分下降趋势越大,同时观察组患者评分下降趋势优于对照组(P<0.05)。神经功能缺损评分、日常生活能力量表评分比较,2组患者治疗前差异无统计学意义(P>0.05),治疗后均有明显改善(P<0.05),并且观察组的评分改善程度显著优于对照组(P<0.05)。对照组总有效率为71.43%,观察组为92.86%,差异有统计学意义(P<0.05);观察组不良反应总发生率为23.81%,对照组为21.43%,差异无统计学意义(P>0.05)。结论脑梗死后抑郁状态的患者,可以采用氟西汀联合奥氮平进行治疗,不仅可以有效提高治疗效果,减轻患者抑郁焦虑症状,同时用药安全性值得肯定,值得临床推广。Objective To explore the improvement effects of fluoxetine and olanzapine on depressive state after cerebral infarction,and to analyze their clinical curative effects.Methods A total of 84 patients with depression after cerebral infarction who were admitted and treated in our hospital from January 2016 to January 2017 were randomly divided into two groups according to random principle.The patients in control group were treated by fluoxetine only,however,the patients in observation group were treated by fluoxetine combined with olanzapine.The scores of Hamilton's Depression Scale(HMMD)and Hamilton anxiety scale(HMMA)at 2w,4w,6w,8w after treatment were observed and compared between two groups.Moreover the neurologic impairment scores at 8w after treatment,and daily living activity scale scores,clinical effects and adverse reaction were also observed and compared between two groups.Results The scores of HMMD and HMMA at 2w,4w,6w,8w after treatment were significantly decreased in both groups(P<0.05),moreover,with the treatment going on,the decrease trend of scores was gradually increased.Meanwhile the decrease trend in observation group was superior to that in control group(P<0.05).Before treatment there were no significant differences in neurologic impairment scores and daily living ability scores between the two groups(P>0.05),however,after treatment there were significant differences between two groups(P<0.05),moreover,the improvement degree in observation group was superior to that in control group(P<0.05).In addition the total effective rate in control group was 71.43%(30/42),which was 92.86%(39/42)in observation group,there was significant difference between two groups(P>0.05).Besides total incidence rate of adverse reactions in observation group was 23.81%(10/42),which was 21.43%(9/42)in control group,there was no significant difference between two groups(P>0.05).Conclusion The patients with depression after cerebral infarction can be treated by fluoxetine combined with olanzapine,which can not only effectivel

关 键 词：氟西汀 奥氮平 脑梗死后抑郁 治疗结果 

分 类 号：R743.33[医药卫生—神经病学与精神病学]