小剂量利培酮联合文拉法辛治疗难治性抑郁症的临床疗效及安全性  

Clinical efficacy and safety of low-dose risperidone combined with venlafaxine in the treatment of refractory depression

作　　者：易凡[1] 欧阳林[1] 黄秋娟 YI Fan;OUYANG Lin;HUANG Qiujuan(Psychology Department,China People′s Liberation Army Joint Logistics Support Force No.909 Hospital/Dongnan Hospital Affiliated to Xiamen University,Fujian Province,Zhangzhou 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九○九医院/厦门大学附属东南医院心理科,福建省漳州市363000

出　　处：《临床合理用药杂志》2023年第12期30-33,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察小剂量利培酮联合文拉法辛治疗难治性抑郁症的临床疗效及安全性。方法选取2020年5月—2022年4月中国人民解放军联勤保障部队第九○九医院收治的138例难治性抑郁症患者为研究对象,按照红蓝球法随机分为对照组与观察组,各69例。对照组予以盐酸文拉法辛片治疗,观察组患者在对照组基础上予以小剂量利培酮片治疗。2组患者均连续治疗4周。比较2组临床疗效,治疗前及治疗4周后汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分、威斯康星卡片分类测验评分、匹兹堡睡眠质量指数(PSQI)评分、世界卫生组织生存质量量表(WHOQOL-100)评分,不良反应。结果观察组治愈率为66.67%,高于对照组的46.38%(χ^(2)=5.779,P=0.016)。治疗4周后,2组HAMA评分、HAMD评分低于治疗前,且观察组低于对照组(P<0.01)。治疗前及治疗4周后,2组完成分类数、持续性错误数、非持续性错误数、总反应数评分比较,差异无统计学意义(P>0.05);治疗4周后,观察组正确反应数评分高于对照组(P<0.01)。治疗4周后,2组PSQI评分低于治疗前,WHOQOL-100评分高于治疗前,且观察组降低/升高幅度大于对照组(P<0.01)。观察组、对照组不良反应总发生率分别为10.14%、7.25%,组间比较差异无统计学意义(χ^(2)=0.365,P=0.546)。结论小剂量利培酮联合文拉法辛应用于难治性抑郁症的疗效确切,有利于改善患者焦虑、抑郁情绪及认知功能,提高睡眠质量和生存质量,且安全性较高。Objective To observe the clinical efficacy and safety of low-dose risperidone combined with venlafaxine in the treatment of refractory depression.Methods A total of 138 cases of patients with refractory depression were selected from May 2020 to April 2022 in China People′s Liberation Army Joint Logistics Support Force No.909 Hospital,which were divided into control group and observation group according to the red and blue ball method,with 69 cases in each group.The control group was given venlafaxine hydrochloride tablets,and the observation group was given low-dose risperidone tablets on the basis of the control group.Both groups were treated continuously for 4 weeks.The clinical efficacy,HAMA score,HAMD score,WCST score,PSQI score,WHOQOL-100 score before and after 4 weeks of treatment and adverse reactions were compared between the two groups.Results The cure rate of the observation group was 66.67%,was higher than 46.38%of the control group(χ^(2)=5.779,P=0.016).After 4 weeks of treatment,the HAMA score and HAMD score of the two groups were lower than those before treatment,and the observation group were lower than control group(P<0.01).Before and after 4 weeks of treatment,there were no statistically significant difference in the scores of CC,RPE,NRPE and RA between the two groups(P>0.05);after 4 weeks of treatment,the RC score of the observation group was higher than that of the control group(P<0.01).After 4 weeks of treatment,the PSQI score of the two groups was lower than that before treatment,and the WHOQOL-100 score was higher than that before treatment,and the decreased or increased of the observation group was greater than that of the control group(P<0.01).The total incidence of adverse reactions in the observation group was 10.14%,which was not statistically significant compared with 7.25%in the control group(χ^(2)=0.365,P=0.546).Conclusion Low-dose risperidone combined with venlafaxine have an exact clinical effect for refractory depression,it is beneficial to improve patients′anxiety,depression

关 键 词：难治性抑郁症 利培酮 文拉法辛 治疗结果 药物不良反应 

分 类 号：R749.4[医药卫生—神经病学与精神病学]