拉莫三嗪联合度洛西汀治疗难治性抑郁症的临床药学价值探讨  

Clinical Pharmacy Value of Lamotrigine Combined with Duloxetine in Treating Refractory Depression

作　　者：孙燕 SUN Yan(Department of Pharmacy,The Second People’s Hospital of Dongying,Dongying,Shandong 257335,China)

机构地区：[1]东营市第二人民医院药学部,山东东营257335

出　　处：《中国医药指南》2025年第11期45-48,共4页Guide of China Medicine

摘　　要：目的本研究旨在评估度洛西汀单独使用和与增效剂拉莫三嗪联合使用治疗难治性抑郁症(TRD)的临床效果。方法选取东营市第二人民医院2022年7月至2024年6月70例TRD患者展开试验观察,按照随机数字表法将患者分对照组(35例,行度洛西汀单药治疗)和研究组(35例,行度洛西汀联合拉莫三嗪治疗),对比分析两组患者药物治疗有效性及安全性。结果研究组药物治疗2周、4周和8周后的HAMD-24评分均低于对照组(P<0.05)。研究组临床治疗总有效率高于对照组(P<0.05)。研究组药物治疗2周、4周和8周后的疾病严重程度(CGI-SI)评分均低于对照组(P<0.05)。研究组药物治疗2周、4周和8周后的脑源性神经营养因子(BDNF)均高于对照组(P<0.05)。治疗8周后,研究组完成连线测验A(TMT-A)所需时间比对照组更短,威斯康星卡片分类测试(WCST)完成分类数、正确应答数均高于对照组,错误应答数和持续性的错误数统计结果低于对照组(P<0.05)。两组患者药物治疗期间各种不良反应发生率的差异无统计学意义(P>0.05)。结论拉莫三嗪与度洛西汀联合用药方案在TRD治疗中表现出良好的有效性及安全性。Objective The purpose of this study is to evaluate the clinical effects of duloxetine alone and in combination with synergist lamotrigine in the treatment-resistant depression(TRD).Methods A total of 70 patients with TRD were selected from the Second People’s Hospital of Dongying City from July 2022 to June 2024 for experimental observation.According to the random number table,the patients were divided into the control group(35 cases were treated with duloxetine alone)and the research group(35 cases were treated with duloxetine combined with lamotrigine),and the efficacy and safety of drug treatment were compared and analyzed between the two groups.Results The research group’s HAMD-24 scores after 2 weeks,4 weeks and 8 weeks of pharmacological treatment were lower than those of the control group(P<0.05).The overall clinical treatment effectiveness rate of the research group was higher than that of the control group(P<0.05).The disease severity(CGI-SI)scores of the research group after 2 weeks,4 weeks,and 8 weeks of pharmacological treatment were lower than those of the control group(P<0.05).The brain-derived neurotrophic factor(BDNF)levels of the research group after 2weeks,4weeks,and 8 weeks of pharmacological treatment were higher than those of the control group(P<0.05).After 8 weeks of treatment,the research group required less time to complete the Trail Making Test A(TMT-A)compared to the control group,and the number of categories completed,correct responses,and significantly lower number of errors and perseverative errors in the Wisconsin Card Sorting Test(WCST)were higher than those of the control group(P<0.05).There was no statistically significant difference in the incidence of various adverse reactions during pharmacological treatment between the two groups of patients(P>0.05).Conclusions The combination of lamotrigine and duloxetine shows good efficacy and safety in the TRD.

关 键 词：难治性抑郁症 认知功能 拉莫三嗪 度洛西汀 药学价值 

分 类 号：R749.41[医药卫生—神经病学与精神病学]