室内光照辅助治疗抑郁症的疗效与安全性研究  

Study on the efficacy and safety of light room therapy as an adjunctive treatment for depression

作　　者：任若佳 卢文婷[1] 高媛媛[1] 李娜[1] 杨丽[1] 赵天宇 郭世杰 黄凡凡 刘不凡 林泉 许月航 靳娜 杨兮 王学义[1] REN Ruojia;LU Wenting;GAO Yuanyuan;LI Na;YANG Li;ZHAO Tianyu;GUO Shijie;HUANG Fanfan;LIU Bufan;LIN Quan;XU Yuehang;JIN Na;YANG Xi;WANG Xueyi(Mental health center of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学精神卫生中心,河北省精神心理疾病临床医学研究中心,河北省精神卫生研究所,河北省精神心理健康评估与干预技术创新中心,石家庄050031 [2]河北医科大学第一医院眼科

出　　处：《中国神经精神疾病杂志》2023年第12期720-726,共7页Chinese Journal of Nervous and Mental Diseases

基　　金：河北省省级科技计划资助(编号:21377711D);河北省引进外国智力项目(编号:YZ202204);河北省医学科学研究课题计划(编号:20230167)。

摘　　要：目的探讨室内光照辅助治疗能否快速改善抑郁症患者的抑郁、焦虑情绪以及光照治疗的安全性。方法纳入2021年9月至2022年12月在河北医科大学第一医院精神卫生中心住院的抑郁症患者,采用随机数字表法随机分为试验组和对照组,试验组在抗抑郁药物治疗的基础上辅助光照治疗,每日室内光照30 min,连续2周,光照治疗结束后继续原有抗抑郁药物治疗2周。对照组规律服用抗抑郁药物治疗4周。基线及治疗每周末采用17项汉密尔顿抑郁量表(Hamilton depression scale,HAMD17)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评定疗效。安全性评价采用患者不良事件自我报告和眼前节照相检查及视力检测。结果共入组80例患者,其中试验组40例,对照组40例。9例脱落患者资料按照末次结转法进行缺失值处理后纳入统计学分析。试验组与对照组在治疗1周末(20.0%vs.0.0%)及2周末(45.0%vs.17.5%)的有效率差异有统计学意义(P<0.05)。4周期间,HAMD17评分时点与组别交互效应有统计学意义(F=9.66,P<0.01),试验组治疗后各时点HAMD17评分低于对照组(P<0.05)。试验组治疗1周末HAMD17总分减分率[中位数与四分位数:33.3%(25.0%,43.3%)vs.13.9%(9.9%,19.8%)]和HAMA总分减分率[中位数与四分位数:22.4%(16.5%,35.3%)vs.14.2%(4.4%,26.9%)]高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率(12.5%vs.10.0%)差异无统计学意义(P=1.00),试验组光照治疗期间无严重不良事件发生,无躁狂或轻躁狂发作,眼科检查无异常。结论与单纯药物治疗相比,室内光照联合药物治疗能够快速改善抑郁症患者的抑郁、焦虑情绪,缩短抑郁症治疗时间,且安全性较好。Objective To explore whether indoor light-assisted therapy can rapidly improve depression and anxiety symptoms in patients with depression,as well as the safety of indoor-light-assisted therapy.Methods From September 2021 to December 2022,patients with depression were recruited from the Mental Health Center of the First Hospital of Hebei Medical University.According to the random number table method,patients were divided into test group and control group.The test group was treated with light therapy 30 minutes from 7:30 am to 8:00 am daily for 2 weeks in addition to antidepressant therapy.Antidepressant therapy was continued after completion of light therapy and patients were followed up for 2 weeks.The control group was treated with regular antidepressants throughout the four-week trial.Hamilton depression scale(HAMD17)and the Hamilton anxiety scale(HAMA)were used to assess the clinical symptoms at the baseline and the end of every week of treatment.Safety was evaluated using patient adverse events,anterior segment photography and visual testing.Results A total of 80 patients were enrolled,including 40 in the test group and 40 in the control group.The data of dropped were processed for missing values and then included in the statistical analysis.At the 1st(20.0%vs.0.0%)and 2nd(45.0%vs.17.5%)weekend of treatment,the response rate in the test group was significantly higher than that in the control group.There was an interaction between the time point and the group in HAMD17 total score(F=9.66,P<0.01).The scores of HAMD17 at the end of every week in the test group were significantly lower than that in the control group(P<0.05).There were significant differences in the reduction rate of total score in HAMD17[33.3%(25.0%,43.3%)vs.13.9%(9.9%,19.8%)]and HAMA[22.4%(16.5%,35.3%)vs.14.2%(4.4%,26.9%)]between the two groups(P<0.05).Incidences of adverse effect were not significantly different between the two groups(12.5%vs.10.0%,P=1.00).There were no severe adverse events or mania was reported in the test group and the eye

关 键 词：光照治疗 室内光照 抑郁症 辅助治疗 快速起效 临床疗效 安全性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]