摘要
目的探讨艾司西酞普兰联合喹硫平治疗首发抑郁症的临床疗效以及对认知功能和神经因子的影响,为抑郁症的临床治疗提供依据。方法选择2018年1月至2019年1月天津市安定医院收治的215例首发抑郁症患者作为研究对象,采用随机数字表法随机分为研究组(117例)和对照组(98例)。研究组给予艾司西酞普兰联合喹硫平治疗,对照组给予艾司西酞普兰治疗,连续治疗8周。分别在治疗前和治疗2、4、8周末,采用汉密尔顿抑郁量表(HAMD)评估治疗效果,应用重复成套神经心理状态测验(RBANS)评估认知功能,应用治疗时出现的症状量表(TESS)评定安全性。分析比较治疗前后两组患者S100B蛋白(S100B)、髓鞘间隙蛋白(MBP)、血清神经营养因子(BDNF)水平变化情况。用SPSS 17.0统计软件进行独立样本t检验、配对t检验和χ^2检验。结果治疗前,两组患者HAMD评分比较,差异无统计学意义(P>0.05);治疗8周后,两组HAMD评分均较本组治疗前明显下降,研究组总有效率(92.3%)明显高于对照组(78.6%),差异均有统计学意义(P<0.05);在治疗第2、4周末,研究组HAMD评分均明显低于对照组,差异均有统计学意义(P<0.05)。在治疗第4、8周末,研究组RBANS得分较对照组明显升高,差异均有统计学意义(P<0.05)。治疗后,两组患者S100B、MBP水平均较本组治疗前明显降低,且治疗后研究组明显低于对照组;治疗后两组患者BDNF水平均明显高于本组治疗前,且治疗后研究组明显高于对照组,差异均有统计学意义(P<0.05,P<0.01)。两组患者TESS评分比较,差异无统计学意义(P>0.05)。结论艾司西酞普兰联合喹硫平治疗首发抑郁症起效快,疗效好,可改善患者认知及神经功能,安全性高。
Objective To explore the clinical efficacy,effects on cognitive function and neurological factors of escitalopram combined with quetiapine in patients with first-onset depression,and to provide the basis for treatment of depression. Methods From January of 2018 to January of 2019,215 patients with first-onset depression in An Ding Hospital of Tianjin were selected as the subjects. The subjects were randomly divided into study group(117 cases,combined treatment of escitalopram with quetiapine for 8 weeks) and control group(98 cases,treatment of escitalopram for 8 weeks). Before treatment and in 2,4,8 weeks after treatment,Hamilton Depression Scale(HAMD) was used to evaluate the clinical efficacy,the Repeatable Battery for the Assessment of Neuropsychological Status Tests(RBANS) was used to evaluate the cognitive function,and the Treatment Emergent Symptom Scale(TESS) was used to evaluate the safety during the treatment. The levels of S100 B protein(S100 B),myelin space protein(MBP) and serum Brain Derived Neurotrophic Factor(BDNF) in the two groups of patients were compared before and after treatment. The independent t test,paired sample t test and χ^2 test were used to analyze the data,the used software was SPSS17.0. Results Before treatment,there was no significant difference of HAMD scores between two groups(P>0.05);after treatment for 8 weeks,HAMD scores in 2 groups decreased significantly,but the total effective rate(92.3%) of study group was significantly higher than that(78.6%) in control group,P <0.05;after treatment for 2 and 4 weeks,HAMD scores in study group were significantly lower than those in control group,P <0.05. In 4 and 8 weeks after treatment,RBANS scores in study group were significantly higher than those in control group,P<0.05.After treatment,the levels of S100 B and MBP in 2 groups were significantly lower than those before treatment;after treatment,the levels of S100 B and MBP in study group were significantly lower than those in control group;after treatment,the levels of BDNF in 2 group
作者
邵红敏
周小梅
罗国帅
王莹
陈清刚
SHAO Hong-min;ZHOU Xiao-mei;LUO Guo-shuai;WANG Ying;CHEN Qing-gang(Community Health Service Center of Hangu street,Tianjin Binhai New District,Tianjin 300480,China;不详)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2020年第7期509-512,共4页
Chinese Journal of Prevention and Control of Chronic Diseases
