舍曲林联合小剂量奥氮平对抑郁焦虑共病患者的疗效  

Efficacy of sertraline combined with low-dose olanzapine in patients with depression and anxiety comorbidity

作　　者：王芳 马元业 杨冬冰 董诚 刘文燕 张子明[1] Wang Fang;Ma Yuanye;Yang Dongbing;Dong Cheng;Liu Wenyan;Zhang Ziming(The Third People's Hospital of Tianshui,Tianshui 741000,China;The Sanatorium for Mental Illness of Veterans in Tianshui,Tianshui 741000,China)

机构地区：[1]甘肃省天水市第三人民医院,甘肃天水741000 [2]甘肃省天水市复退军人精神病疗养院,甘肃天水741000

出　　处：《四川精神卫生》2021年第2期135-138,共4页Sichuan Mental Health

摘　　要：目的观察舍曲林联合小剂量奥氮平对抑郁焦虑共病的疗效、安全性及其对患者睡眠质量的影响,为抑郁焦虑共病的治疗提供参考。方法纳入2019年10月-2020年8月在甘肃省天水市第三人民医院和天水市复退军人精神病疗养院门诊就诊、符合《国际疾病分类(第10版)》(ICD-10)抑郁发作和广泛性焦虑障碍诊断标准的121例患者为研究对象,按照随机数字表法分为研究组(n=61)和对照组(n=60),研究组采用舍曲林联合小剂量奥氮平治疗,对照组采用舍曲林治疗,观察期8周。于治疗前和治疗后第1、2、4、6、8周采用汉密尔顿抑郁量表17项版(HAMD-17)和汉密尔顿焦虑量表(HAMA)评定病情严重程度,采用匹兹堡睡眠质量指数量表(PSQI)评定睡眠质量,采用副反应量表(TESS)评定药物不良反应。结果治疗后,两组HAMD-17、HAMA和PSQI评分均低于治疗前,差异均有统计学意义(P均<0.05);治疗后各时点,研究组HAMD-17、HAMA和PSQI评分均低于对照组,差异均有统计学意义(P均<0.05)。结论舍曲林联合小剂量奥氮平与单一舍曲林对抑郁焦虑共病的治疗均有效,但联合用药在改善焦虑和失眠症状方面的效果更好、安全性更高。ObjectiveTo observe the efficacy and safety of sertraline combined with low-dose olanzapine in the treatment of depression and anxiety comorbidity and its effect on sleep quality,so as to provide references for the related clinical treatment.MethodsA total of 121 patients who met the diagnostic criteria of International Classification of Diseases,tenth edition(ICD-10)for depressive episode and generalized anxiety disorder in The Third People’s Hospital of Tianshui and the Sanatorium for Mental Illness of Veterans in Tianshui from October 2019 to August 2020 were enrolled,and they were divided into two groups according to the random number table method.Study group(n=61)received sertraline combined with low-dose olanzapine,while control group(n=60)received sertraline only.Then the disease severity degree,sleep quality and adverse reactions were assessed using Hamilton Depression Scale-17 item(HAMD-17),Hamilton Anxiety Scale(HAMA),Pittsburgh Sleep Quality Index(PSQI)and Treatment Emergent Symptom Scale(TESS)at the baseline,1st,2nd,4th,6th and 8th weekend,respectively.ResultsPost-treatment HAMD-17,HAMA and PSQI scores in both groups were lower than those before treatment(P<0.05).At each time point after treatment,HAMD-17,HAMA and PSQI scores of study group were lower than those of control group,with statistical significance(P<0.05).Conclusion Sertraline alone and its combination with low-dose olanzapine are both effective in the treatment of depression and anxiety comorbidity,while the combination therapy achieves better efficacy and higher safety in alleviating anxiety and insomnia symptoms.

关 键 词：舍曲林 奥氮平 抑郁焦虑共病 睡眠 

分 类 号：R749.4[医药卫生—神经病学与精神病学]