摘要
目的探讨帕罗西汀与阿米替林联合用药的合理性有效性及其临床安全性。方法将60例双相抑郁症患者单盲法随机分为2组，对照组30例给予阿米替林，2粒／d顿服；观察组30例在阿米替林的基础上给予帕罗西汀，1粒／d顿服；分别于治疗前和治疗第1、3、6周进行HAMD、TESS量表评分，比较临床疗效与不良反应；并抽取患者空腹静脉血，以荧光偏振免疫法检测各期患者血清中同型半胱氨酸（Homocysteine，Hcy）的含量。所得数据经SPSS16．0统计软件分析处理，有效率比较行Fisher检验，HAMD、TESS量表评分、Hcy含量的比较行t检验。结果观察组的临床有效率为90．0％（27例），显著高于对照组的66．7％（20例）（）（2=4．812，P=0．029）；治疗后2组患者的HAMD评分均有不同程度的下降，观察组治疗后3周和6周的HAMD评分显著低于对照组（t=3．167～5．841，P=0．015—0．001）。治疗期间，观察组的不良反应发生率为36．7％（9例），显著小于对照组的70．0％（19例），x2=6．695，P=0．010；且TESS各项评分显著低于对照组（t=8．599～10．67，P=0．000）。此外，治疗后各时段观察组Hcy含量显著低于对照组（t=2．447～4．014，P=0．035～0．015）。结论帕罗西汀与阿米替林联合治疗双相抑郁症在起效速度和临床疗效方面均具有较高优势，且能够减少阿米替林单药应用时的毒副作用，安全性高。
Objective To investigate the reasonableness, efficacy and safety of paroxetine and amitriptyline combination therapy for the bipolar depression. Methods All 60 cases of bipolar depression were randomized into two groups for sin- gle-blind study. 30 patients in the control group received amitriptyline ,2/d ;30 patients in the observation group received amitriptyline,2 pills/d, and paroxetine, l pill/d. HAMD and TESS teats were done before the treatment and 1,3,6 weeks after the treatment to compare the clinical efficacy and adverse reactions. At the same time, the levels of serum Hey at each time points were determined by using fluorescence polarization immunoassay. Fisher test was used to compare the ef- ficiency, and t test was used to compare the difference in Hey level. Results The effective rate of the observation group was 90.0% , significantly higher than the control group （66.7 % ） , X2 = 4.812, P = 0. 029. HAMD score decreased in both group. After 3 and 6 weeks of treatment, HAMD score in the observation group was significantly lower than that in the con- trol group（ t = 3. 167,P = 0.015, t = 5. 841,P = 0. 001 ）. The incidence of adverse reactions in the observation group was significantly lower than the control group（ 36.7% vs. 70.0% ,P 〈 0.05 ） ;TESS scores were significantly lower than the control group（ t = 8. 599, P = 0.000, t = 10.67, P = 0.000 ）. After treatment Hey levels in the observation group were sig- nificantly lower than that in the control group（ t = 2. 447,P = 0.035,t = 4. 014,P = 0. 015 ）. Conclusion The combined therapy of paroxetine and amitriptyline has high action speed, efficacy and security to treat bipolar depression.
出处
《中华全科医学》
2014年第4期562-564,共3页
Chinese Journal of General Practice
