摘要
目的 :探讨控制围绝经期抑郁症的最佳治疗方案。方法 :将围绝经期抑郁症患者 16 8例随机分配入 3组 :单用紫竹爱维组 6 2例 ,前 2周每日晨起口服紫竹爱维 1片 ,后 6周改为隔日晨起服 1片 ;单用赛乐特组 39例 ,每日晨起口服 1片 ;二者合用组 6 7例 ,紫竹爱维和赛乐特同时服用 ,剂量及用法与单用组相同。 3组疗程均为 8周。观察治疗前后各组抑郁评分 (HAMD)、围绝经期症状评分 (KMI)、血清促卵泡生成素 (FSH)和雌二醇 (E2 )水平及药物副作用。结果 :(1)HAMD和KMI的变化情况 :治疗后各组总评分均下降 ,差异有高度显著性 (P <0 .0 0 1)。合用组减分率最高 ,分别达到 78.6 1%和 80 .16 %。合用组、紫竹爱维组、赛乐特组总有效率分别为 :94 .0 2 %、75 .81%、79.4 9%及 97.0 2 %、93.5 5 %、4 8.72 % ,HAMD合用组与其他两组相比 ,差异有高度显著性 (P <0 .0 1) ,KMI前 2组分别与赛乐特组相比 ,差异有高度显著性 (P <0 .0 0 1) ;(2 )HAMD评分中睡眠障碍及焦虑 /躯体化两个因子得分的变化情况 :各组总评分均下降 ,差异有高度显著性 (P <0 .0 0 1) ,合用组下降最明显 ;(3)FSH和E2水平测定 :合用组、紫竹爱维组FSH水平下降 ,差异有高度显著性 (P <0 .0 1) ,E2 水平无明显变化。赛乐特组FSH水平上升明显 ,E2
Objective:To explore the best regiment for treatment o f premenopausa l depression. Methods:168 premenopausal women with depression were divided into 3 groups randomly: 62 cases in Tibolone group were treated with oral Tibolone T ablets 2.5mg once a day during the morning in the first 2 weeks, then 2.5mg once every other day during the last 6 weeks.39 cases in Seroxat group were treated with oral Seroxat 20mg once a day in the total 8 weeks. 67 cases in combining gr oup were treated with Tibolone Tablets and Seroxat together the same dose and re gimen as the 2 previous groups. The curative effect was assessed respectively by HAMD, Kupperman measurement index (KMI), serum FSH, E 2.Result s:(1)The scores of HAMD and KMI were both decreased in the 3 groups, t he difference were statistically significant (P<0.001). Decreme nts in combining group were the highest (78.61% and 80.16%). The total valid rat es in combining group, Tibolone group and Seroxat group were 94.02%,75.81%,79.49 % and 97.02%, 93.55%, 48.72%.,the difference between combining group and other 2 groups in HAMD was statistically significant (P<0.01). The di fference between Seroxat group and other 2 groups in KMI was statistically significant (P<0.001). (2)The s cores of Insomnia and Anxiety/Somatic in HAMD were both decreased in the 3 groups, the difference was statistically significant (P<0.001). The combining group h ad the most decre ase in the 3 groups. The differences were statistically significant (P<0.001). (3)The level of serum FSH decreased in the combining group and Tibolone group bu t increased in Seroxat group. The difference were statistically significant (P<0.01),The level of serum E 2 in the Seroxat group was decrease d. It is not improved significantly in the other 2 groups.(4)The incidence of s ide-effect in the 3 groups was:23.88%、17.74 %、53.84%. The Seroxat group was t he highest, the difference with other 2 groups was statistically significant(P<0.001).The rate of persons who had abandoned the treatment w as:2.99%
出处
《现代妇产科进展》
CSCD
2004年第6期438-441,共4页
Progress in Obstetrics and Gynecology
