基于药物基因检测使用文拉法辛治疗抑郁症的临床效果  

Clinical study on the treatment of depression with venlafaxine under the guidance of pharmacogenomics testing

作　　者：许锦冰 黄炜[1] 郭华贵[1] 黄史青[1] 汤超华 梁嘉权 黎雪松[1] Xu Jinbing;Huang Wei;Guo Huagui;Huang Shiqing;Tang Chaohua;Liang Jiaquan;Li Xuesong(The Third People's Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第三人民医院,广东佛山528000

出　　处：《四川精神卫生》2021年第3期239-242,共4页Sichuan Mental Health

基　　金：2019年佛山市自筹经费类科技计划项目(医学类科技攻关项目)(项目名称:个体化用药基因检测对改善抑郁障碍药物治疗预后作用研究,项目编号:1920001001782)。

摘　　要：目的探讨药物基因检测下使用文拉法辛治疗抑郁症的效果和安全性,为个体化用药提供参考。方法纳入符合《国际疾病分类(第10版)》(ICD-10)抑郁发作诊断标准的66例患者为研究对象。将药物基因检测报告建议并选用文拉法辛治疗的患者分为研究组(n=32),医生与患者协商后决定使用文拉法辛治疗的患者为对照组(n=34)。于治疗前及治疗2、4、6、8周末使用汉密尔顿抑郁量表24项版(HAMD-24)评定临床疗效,于治疗前及治疗8周末使用席汉残疾量表(SDS)评定患者的社会功能,于治疗后采用副反应量表(TESS)评定不良反应发生情况。结果治疗4、6、8周末,研究组HAMD-24评分均低于对照组,差异均有统计学意义(t=2.344、4.316、5.760,P<0.05或0.01);治疗8周末,研究组SDS评分低于对照组,差异有统计学意义(t=2.173,P<0.05),研究组不良反应发生率低于对照组,差异有统计学意义(χ^(2)=5.720,P<0.05)。结论基于药物基因检测使用文拉法辛治疗抑郁症,可能有助于改善患者的抑郁情绪,且安全性更好。Objective To investigate the efficacy and safety of venlafaxine in the treatment of depression under the guidance of pharmacogenomics testing,and to provide references for individualized medication.Methods A total of 66 patients who met the diagnostic criteria of International Classification of Diseases,tenth edition(ICD-10)for depressive episode were included in the study.Patients who were recommended to be treated with venlafaxine in the pharmacogenomics testing report were divided into study group(n=32),and those who were decided to be treated with venlafaxine by doctors after consultation with patients were divided into control group(n=34).At the baseline and the end of the 2nd,4th,6th and 8th weekend of treatment,Hamilton Depression Scale-24 item(HAMD-24)was adopted to evaluate the clinical efficacy.Meanwhile,Sheehan Disability Scale(SDS)was applied to measure the social function of patients at the baseline and the end of the 8th weekend of treatment.After treatment,Treatment Emergent Symptom Scale(TESS)was used to assess the incidence of adverse reactions.Results At the end of the 4th,6th and 8th weekend of treatment,HAMD-24 scores in the study group were all lower than those in the control group,with statistical differences(t=2.344,4.316,5.760,P<0.05 or 0.01).At the end of the 8th weekend of treatment,SDS score of the study group was lower than that of the control group,with statistical difference(t=2.173,P<0.05).The adverse reaction rate in the study group was lower than that in the control group,with statistical difference(χ^(2)=5.720,P<0.05).Conclusion Treatment of depression with venlafaxine based on pharmacogenetic testing is an effective and safe way to alleviate the depression symptoms in patients.

关 键 词：药物基因检测 文拉法辛 抑郁症 个体化治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]