量化治疗与常规治疗对抑郁症病人疗效及安全性比较  

A COMPARISON OF EFFICACY AND SAFETY BETWEEN QUANTITATIVE TREATMENT AND ROUTINE TREATMENT IN PATIENTS WITH DEPRESSION

作　　者：黄飞[1] 姜祥智[1] 徐勇 HUANG Fei;JIANG Xiangzhi;XU Yong(Department of Psychiatry,Qingdao Mental Health Center,Qingdao 266034,China)

机构地区：[1]青岛市精神卫生中心精神科,山东青岛266034 [2]青岛市市立医院临床心理科

出　　处：《青岛大学学报（医学版）》2019年第5期548-551,共4页Journal of Qingdao University(Medical Sciences)

摘　　要：目的 比较量化治疗与常规治疗对抑郁症病人的疗效及安全性。方法 将79例入组门诊抑郁症病人随机分为量化治疗组(39例)和常规治疗组(40例),两组病人均进行为期8周的系统治疗,治疗药物仅限于艾司西酞普兰(10~20mg/d)或度洛西汀(20~60mg/d)。量化治疗组使用快速抑郁自评量表(QRDS-SR)和不良反应耐受量表(FIBSER)监测病情及调整药物,常规治疗组根据医师的临床经验调整药物。两组病人均于治疗第2、4、6、8周末使用汉密尔顿抑郁量表(HAMD)评估病情。结果 治疗第2、4、6、8周末,两组病人HAMD评分均较治疗前下降,差异有显著性(F=35.20、52.99,P<0.01);治疗第8周末,量化治疗组HAMD评分明显低于常规治疗组(F=2.26,P<0.05)。量化治疗组痊愈率和缓解率明显高于常规治疗组(χ2=7.25、6.05,P<0.05),且痊愈时间与缓解时间明显短于常规治疗组(logrank=6.25、4.12,P<0.05)。两组不良反应比较差异无显著性(P>0.05)。结论 对于门诊抑郁症病人,两种治疗方法的安全性相当,但量化治疗较传统的常规治疗更有效且起效更快。Objective To compare the efficacy and safety between quantitative treatment and routine treatment in patients with depression. Methods Seventy-nine outpatients with depression were randomly divided into quantitative treatment group (39 cases) and routine treatment group (40 cases). Both groups received systematic therapy for 8 weeks. And drugs were limited to escitalopram (10-20 mg/d) or duloxetine (20-60 mg/d). The Quick Inventory of Depressive Symptomatology-Self Report and the Frequency, Intensity, and Burden of Side Effects Rating Scale were used in the quantitative treatment group to monitor the condition and adjust medication, while drugs in the routine treatment group were adjusted according to physician’ clinical experience. The Hamilton Depression Scale (HAMD) was used to assess the conditions in both groups at the end of the 2nd, 4th, 6th and 8th weeks of treatment. Results At the end of the 2nd,4th,6th and 8th weeks of treatment, both groups showed a significant reduction in HAMD score ( F =35.20 and 52.99, P <0.01);at the end of the 8th week, the quantitative treatment group had a significantly lower HAMD score than the routine treatment group ( F =2.26, P <0.05). Compared with the routine treatment group, the quantitative treatment group had significantly higher cure rate and remission rate (χ 2=7.25 and 6.05, P <0.05) and significantly shorter cure time and remission time (log rank=6.25 and 4.12, P <0.05). However, there was no significant difference in adverse reactions between the two groups ( P >0.05). Conclusion For outpatients with depression, the safety of the two treatments is comparable, but the quantitative treatment is more effective and efficient than the routine treatment.

关 键 词：抑郁症 药物监测 治疗结果 

分 类 号：R749.41[医药卫生—神经病学与精神病学]