文拉法辛联合不同剂量坦度螺酮治疗重性抑郁障碍研究  

Study on venlafaxine combined with different doses of tandospirone in the treatment of major depressive disorder

作　　者：胡艳[1] 汪卫华 纪菊英 周蓉 刘羽 刘康 李传亮 姜亚梅 李双玉 HU Yan;WANG Wei-hua;JI Ju-ying;ZHOU Rong;Liu Yu;LIU Kang;LI Chuan-liang;JIANG Ya-mei;LI Shuang-yu(Dept of Psychology,Wuxi Clinical College,Anhui Medical University,Changzhou 213003,China)

机构地区：[1]安徽医科大学无锡临床学院,江苏常州213003 [2]联勤保障部队第904医院全军精神医学中心心理科

出　　处：《临床精神医学杂志》2024年第5期344-348,共5页Journal of Clinical Psychiatry

基　　金：厅市共建中枢神经系统药物四川省重点实验室开发课题(210024-01SZ)。

摘　　要：目的:探讨文拉法辛联合不同剂量坦度螺酮治疗重性抑郁障碍患者的疗效及对认知功能的影响。方法:选取重性抑郁障碍患者100例,随机分为单药组36例(单用文拉法辛)、联合低剂量组34例(文拉法辛联用30 mg/d坦度螺酮)和联合高剂量组30例(文拉法辛联用60 mg/d坦度螺酮),治疗6周。分别于治疗前、治疗1、2、4、6周末采用17项汉密尔顿抑郁量表(Hamilton depression scale 17 items,HAMD-17)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估疗效;采用数字符号转换测验(digit symbol substitution test,DSST)、认知功能缺陷自评问卷(perceived deficit questionnaire for depression,PDQ-D)评估认知功能。结果:治疗前和治疗1、2、4、6周,3组HAMD-17评分的时间效应和组别效应均有统计学意义(F=306.712、F=5.344,P<0.05),HAMA评分的时间效应、组别效应以及时间与组别的交互效应均有统计学意义(F=228.377、F=8.054、F=4.474,P<0.05或P<0.001)。3组DSST评分和PDQ-D评分的时间效应、组别效应以及时间与组别的交互效应均有统计学意义(P<0.05或P<0.001)。结论:文拉法辛联合坦度螺酮治疗重性抑郁障碍能够缩短起效时间、提高疗效及改善认知功能,高剂量坦度螺酮较低剂量起效更快、抗焦虑和改善认知功能作用更明显。Objective:To explore the efficacy and cognitive function on venlafaxine combined with different doses of tandospirone in treating patients with major depressive disorder(MDD).Method:A total of 100 MDD patients were selected and randomized into the monotherapy group(venlafaxine only,36 patients),the combined low-dose group(venlafaxine combined with 30 mg/d tandospirone,34 patients)and the combined high-dose group(venlafaxine combined with 60 mg/d tandospirone,30 patients),and were treated for 6 weeks.The efficacy was assessed by Hamilton depression scale(HAMD-17)and Hamilton anxiety scale(HAMA)at baseline,at the end of week1,week2 and week4 after treatment,respectively.Cognitive function was assessed by the digit symbol substitution test(DSST)and the perceived deficit questionnaire for depression(PDQ-D).Results:At baseline and 1,2,4,6 weeks after treatment,the time effect and group effect of HAMD-17 scores among the three groups were statistically significant(F=306.712,F=5.344,P<0.05),and the time effect,group effect as well as interaction effect of time and group of HAMA scores were statistically significant(F=228.377,F=8.054,F=4.474,P<0.05 or P<0.001).The time effect,group effect,as well as interaction effect of time and group of DSST scores and PDQ-D scores among the three groups were statistically significant(P<0.05 or P<0.001).Conclusion:Venlafaxine combined with tandospirone in treating MDD patients can shorten the onset of action,improve efficacy and cognitive function.Higher doses of tandospirone have a faster onset of action and more pronounced anxiolytic and cognitive function improvement effects than lower doses.

关 键 词：重性抑郁障碍 文拉法辛 坦度螺酮 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]