艾司西酞普兰联合舍曲林治疗心内科门诊焦虑/抑郁患者的疗效分析  

Therapeutic efficacy of escitalopram and sertraline in the treatment of outpatients with anxiety or depression in a cardiology setting

作　　者：刘琴[1] 彭楠茵 张雅楠 金超 龚山 宁亮 肖轶[1] 余国龙[1] Qin Liu;Nan-yin Peng;Ya-nan Zhang;Chao Jin;Shan Gong;Liang Ning;Yi Xiao;Guo-long Yu(Department of Cardiology,Xiangya Hospital,Central South University,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅医院心内科,湖南长沙410008

出　　处：《中国现代医学杂志》2022年第2期64-68,共5页China Journal of Modern Medicine

基　　金：湖南省自然科学基金(No:2020JJ4921)。

摘　　要：目的探讨艾司西酞普兰与舍曲林治疗心内科门诊焦虑/抑郁患者的临床疗效及安全性。方法选取2018年8月—2019年4月中南大学湘雅医院心内科门诊中100例心理障碍并躯体化症状患者。根据不同治疗方法将患者分为艾司西酞普兰组与舍曲林组,分别采用艾司西酞普兰与舍曲林治疗,疗程8周。治疗前与治疗后第4周、第8周采用患者健康问卷躯体症状群量表(PHQ-15)、广泛性焦虑量表(GAD-7)和患者健康问卷抑郁症状群量表(PHQ-9)评定临床症状,治疗第8周采用临床疗效总评量表(CGI-GI)、副反应量表(TESS)进行疗效和副反应评定。结果两组患者治疗前、治疗后第4周、治疗后第8周PHQ-15评分比较,经重复测量设计的方差分析,结果:(1)不同时间点的PHQ-15评分有差异(F=242.604,P<0.05);(2)两组患者PHQ-15评分有差异(F=1.207,P<0.05);(3)两组患者PHQ-15评分的变化趋势无差异(F=2.400,P<0.05)。两组患者治疗前、治疗后第4周、治疗后第8周PHQ-9评分的比较,经重复测量设计的方差分析,结果如下:(1)不同时间点的PHQ-9评分有差异(F=136.784,P<0.05);(2)两组患者PHQ-9评分无差异(F=2.016,P<0.05);(3)两组患者PHQ-9评分的变化趋势有差异(F=4.013,P<0.05)。两组患者治疗前、治疗后第4周、治疗后第8周GAD-7评分比较,经重复测量设计的方差分析,结果如下:(1)不同时间点的GAD-7评分有差异(F=198.537,P<0.05);(2)两组患者GAD-7评分有差异(F=6.606,P<0.05);(3)两组患者GAD-7评分的变化趋势有差异(F=9.774,P<0.05)。艾司西酞普兰组治疗后第8周的CGI-GI较舍曲林组低(P<0.05)。两组患者治疗后第8周的TESS各指标比较,差异无统计学意义(P>0.05)。两组间因副反应的退出试验率比较,差异无统计学意义(P>0.05)。结论艾司西酞普兰与舍曲林治疗心内科门诊焦虑/抑郁患者并躯体化症状均有显著疗效及良好的安全性,但与舍曲林相比较,艾司西酞普兰疗效更加显著,且安�Objective To explore the efficacy and safety of escitalopram and sertraline in the treatment of anxiety or depression with somatic symptoms in outpatients of the Department of Cardiology.Methods From August 2018 to April 2019,a total of 100 outpatients with psychological disorders and somatic symptoms in a cardiology setting were randomly divided into escitalopram group and sertraline group,treated with either escitalopram or sertraline for 8 weeks.The clinical symptoms were assessed via the Patient Health Questionnaire-15(PHQ-15),the Generalized Anxiety Disorder 7-Item(GAD-7)and the Patient Health Questionnaire-9(PHQ-9)before treatment,and 4 weeks and 8 weeks after treatment.At the 8 th week,the Clinical Global Impression-Global Improvement Scale(CGI-GI)and Treatment Emergent Symptom Scale(TESS)were used to evaluate the efficacy and side effects of the treatment.Results The scores of PHQ-15,PHQ-9 and GAD-7 at the 4 th and 8 th week of the treatment were compared with those before treatment,which exhibited that the scores of PHQ-15(F=242.604,P<0.05),PHQ-9(F=136.784,P<0.05)and GAD-7(F=198.537,P<0.05)were different among the distinct time points,and that the GAD-7 score(F=6.606,P<0.05)rather than PHQ-15(F=1.207,P>0.05)and PHQ-9 score(F=2.016,P>0.05)was different between the groups.In addition,the change trend of PHQ-9 score(F=4.013,P<0.05)and that of GAD-7 score(F=9.774,P<0.05)instead of that of PHQ-15 score(F=2.400,P>0.05)were different between the two groups.The CGI-GI score was lower in the escitalopram group relative to sertraline group8 weeks after the treatment(P<0.05).However,the rate of all symptoms as assessed via TESS was not different between the two groups 8 weeks after the treatment(P>0.05),and there was no difference in the rate of withdrawal due to adverse reactions between the groups(P>0.05).Conclusions Escitalopram and sertraline are both effective and safe in the treatment of outpatients with anxiety or depression complicated with somatic symptoms in a cardiology setting.Nevertheless,escitalopram

关 键 词：心血管疾病 焦虑 抑郁 治疗结果 

分 类 号：R541[医药卫生—心血管疾病]