SSRIs联合不同剂量坦度螺酮治疗伴有焦虑抑郁症的疗效和安全性  

Efficacy and safety of SSRIs combined with different doses of tandospirone in the treatment of depressive disorder with anxiety symptom

作　　者：高庆 李志雄 杨亚黎 郑占营 李永宏 高英 玉素甫江.依明 李喆[1] GAO Qing;LI Zhixiong;YANG Yali;ZHENG Zhanying;LI Yonghong;GAO Ying;YUSUFUJINAG·Yiming;LI Zhe(Mental Health Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Department of Clinical Psychology,Karamay Municipal People′s Hospital, Karamay,Xinjiang 830054,China;Department of Clinical Sleep Medicine,Karamay Municipal People′s Hospital,Karamay,Xinjiang 830054,China;Department of Geriatrics, Karamay Municipal People′s Hospital,Karamay,Xinjiang 830054,China)

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]新疆克拉玛依市人民医院临床心理科,830054 [3]新疆克拉玛依市人民医院临床睡眠科,830054 [4]新疆克拉玛依市人民医院老年科,830054

出　　处：《重庆医学》2018年第32期4126-4129,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81501174);四川省科学技术厅课题(2017SZ0049);四川省卫生和计划生育委员会科研课题(17PJ080);中央高校基本科研基金(2017SCU11072)

摘　　要：目的探讨选择性5-羟色胺再摄取抑制剂(SSRIs)联合不同剂量坦度螺酮治疗伴有焦虑抑郁症的临床疗效与安全性。方法将146例伴焦虑的抑郁症患者根据治疗药物不同分为3组,其中SSRIs治疗51例(单药组),SSRIs联合低剂量坦度螺酮治疗47例(联合低剂量组),SSRIs联合高剂量坦度螺酮治疗48例(联合高剂量组),疗程均为6周。3组患者治疗前及治疗后1、2、4、6周末运用汉密尔顿抑郁量表24项(HAMD-24)、汉密尔顿焦虑量表(HAMA)评定疗效,不良反应量表(TESS)评定不良反应。结果与治疗前比较,3组患者治疗后HAMD-24及HAMA评分均明显降低(P<0.01);2、4、6周末时,联合低、高剂量组HAMD-24和HAMA评分比单药组更低(P<0.01);两两比较发现,1周末时,联合高剂量组HAMA评分低于联合低剂量组(P=0.03);2周末时,联合高剂量组HAMA及HAMD-24评分均低于联合低剂量组(P<0.05)。在6周末时联合低、高剂量组患者疗效均明显高于单药组(P<0.05),联合低、高剂量组患者疗效比较差异无统计学意义(P=0.48)。3组患者不良反应比较差异无统计学意义(χ2=0.43,P=0.81)。结论 SSRIs联合坦度螺酮能快速有效缓解伴有焦虑的抑郁症状,高剂量的坦度螺酮较低剂量有更明显的快速抗焦虑作用,值得临床推广。Objective To investigate the efficacy and safety of selective serotonin reuptake inhibitors(SSRIs)combined with different doses of tandospirone in the treatment of depressive disorder with anxiety symptom.Methods A total of 146 depressive patients with anxiety symptom were divided into three groups according to the different medicines.Among them,51 cases received SSRIs therapy(the single medicine group),47 cases received SSRIs combined with low dose of tandospirone therapy(the low dose group),and 48 cases received SSRIs combined with high dose of tandospirone therapy(the high dose group),the treatment course was 6 weeks.The efficacy was evaluated with Hamilton Rating Scale for depression 24 items(HAMD-24)and Hamilton Rating Scale for anxiety(HAMA)before treatment and the end of 1,2,4,and 6 weeks after treatment.The side effect was evaluated with Treatment Emergent Symptoms Scale(TESS).Results HAMD-24 and HAMA scores significantly decreased after treatment in the three groups(P<0.01);HAMD-24 and HAMA scores of both the low and high dose groups were lower than those of the single medicine group at the end of 2,4 and 6 weeks(P<0.01);HAMA score of the high dose group was lower than that of the low dose group at the end of 1 week(P=0.03);HAMA and HAMD-24 scores of the high dose group were lower than those of the low dose group at the end of 2 week(P<0.05).Both the low and high dose group showed higher efficacy than the single medicine group(P<0.05),but there was no significant difference between the two groups(P=0.48).The side effect showed no significant difference among the three groups(χ2=0.43,P=0.81).Conclusion SSRIs combined with tandospirone can improve depression accompany anxiety symptom quickly and effectively,the high dose of tandospirone can improve the anxiety symptom faster,which has the value of clinic application.

关 键 词：选择性5-羟色胺再摄取抑制剂 坦度螺酮 抑郁症 焦虑 

分 类 号：R749.4[医药卫生—神经病学与精神病学]