坦度螺酮對米那普侖治療抑郁癥的增效作用對照研究

徐麗莉　李春陽　劉俊賢　胡敏儀

【摘要】 目的：探討坦度螺酮對米那普侖治療抑郁癥患者的增效作用，為臨床優(yōu)化治療提供依據(jù)。方法：選取2017年11月-2018年6月本院60例抑郁癥患者，按隨機(jī)數(shù)字表法分為聯(lián)用組與單用組，每組30例，聯(lián)用組用坦度螺酮聯(lián)合米那普侖治療，單用組單用米那普侖治療，兩組均治療8周。應(yīng)用漢密頓抑郁量表（HAMD）、漢密頓焦慮量表（HAMA）評定療效，副反應(yīng)量表（TESS）評定安全性和不良反應(yīng)。結(jié)果：治療前兩組HAMD與HAMA評分比較，差異均無統(tǒng)計學(xué)意義（P>0.05）;治療2、4、8周，聯(lián)用組HAMD及HAMA評分均低于單用組（P<0.01）。聯(lián)用組顯效率高于單用組（P<0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論：坦度螺酮聯(lián)合米那普侖治療抑郁癥的效果好于單獨應(yīng)用米那普侖治療。

【關(guān)鍵詞】 抑郁癥; 米那普侖; 坦度螺酮

Comparative Study on the Synergistic Effect of Tandospirone on the Treatmen of Depression with Milnacipran/XU Lili，LI Chunyang，LIU Junxian，et al.//Medical Innovation of China，2019，16（22）：0-041

【Abstract】 Objective：To investigate the synergistic effect of Tandospirone on the treatment of depression patients with Milnacipran，and to provide evidence for clinical optimal treatment.Method：60 patients with depression in our hospital from November 2017 to June 2018 were selected and divided into combined group and alone group according to the random number table method，30 cases in each group.The combined group was treated with Tandospirone combined with Milnacipran，the alone group was treated with Milnacipran alone，both groups were treated for 8 weeks.The efficacy was assessed by Hamilton depression scale（HAMD）and Hamilton anxiety scale（HAMA），the safety and adverse reactions were assessed by treatment emergent symptom scale（TESS）.Result：There were no significant differences in HAMD and HAMA scores between the two groups before treatment（P>0.05）.At the 2，4，8 week of treatment，HAMD and HAMA scores of the combined group were lower than those of the alone group（P<0.01）.The marked effective rate of the combined group was higher than that of the alone group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：The effect of Tandospirone combined with Milnacipran in the treatment of depression is better than that of Milnacipran alone.

【Key words】 Depression; Milnacipran; Tandospirone

First-authors address：Shunde Wuzhongpei Memorial Hospital of Foshan City in Guangdong Province，F(xiàn)oshan 528300，China

doi：10.3969/j.issn.1674-4985.2019.22.010

抑郁癥是一種常見的精神疾病，主要臨床特征是思維遲緩、心境低落、意志活動減退等癥狀，嚴(yán)重的患者可出現(xiàn)自殺觀念及行為。通常情況下，抑郁與焦慮是并存的，國內(nèi)外相應(yīng)研究發(fā)現(xiàn)60%～90%的抑郁癥人群同時伴有焦慮癥狀[1]?？挂钟羲幰话阃瑫r具有抗抑郁和抗焦慮的雙重作用，被廣泛用于抑郁癥的治療，但抗抑郁藥不管是SSRIs類藥物還是SNRI類藥物，均存在起效慢、療效不夠理想的缺點[2]。國外文獻(xiàn)報道，坦度螺酮作為一種新型抗焦慮藥，近年來開始有研究表明，其可增強(qiáng)抑郁癥患者抗抑郁藥的效果[3]。國內(nèi)已有文獻(xiàn)報道坦度螺酮聯(lián)合SSRI類抗抑郁藥有提高抑郁癥的療效、縮短起效時間的優(yōu)點[4-5]。本研究探討應(yīng)用坦度螺酮合用米那普侖治療抑郁癥的療效和安全性，國內(nèi)外文獻(xiàn)報道較少，旨在為抑郁癥的優(yōu)化治療提供更多選擇，現(xiàn)報道如下。