摘要
目的探讨丙戊酸钠缓释片联合小剂量喹硫平治疗青少年抑郁发作(AMDD)伴非自杀性自伤(NSSI)行为的临床疗效及对血清甲状腺激素的影响。方法将2020年1月至2022年4月芜湖市第四人民医院收治的108例AMDD伴NSSI患者纳入本次前瞻性研究,然后采用区组随机分成研究组和对照组,各54例,研究组患者治疗方案:喹硫平+丙戊酸钠缓释片,对照组患者治疗方案:单纯丙戊酸钠缓释片。药物治疗持续8周。记录并比较两组治疗前及治疗8周后的汉密尔顿抑郁量表(HAMD-17)评分、汉密尔顿焦虑量表(HAMA)评分、冲动量表(BIS-II)评分,自我伤害行为筛选量表评分、血清甲状腺激素[促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)],临床疗效及不良反应发生情况。结果两组共计有3例患者脱落(研究组2例,对照组1例)。治疗8周后,研究组的HAMD-17、HAMA评分分别为(10.08±2.08)、(9.62±2.54)分,较对照组[(12.74±1.95)、(12.74±2.60)分]显著下降,差异均有统计学意义(P<0.05)。研究组治疗8周后的BIS-11总分、自我伤害行为筛选量表总分分别为(35.45±8.90)、(11.04±2.01)分,较对照组[(57.33±9.02)、(17.16±2.19)分]显著下降,差异均有统计学意义(P<0.05)。治疗8周后,两组血清TSH、FT3和FT4差异均无统计学意义(P>0.05)。治疗8周后,研究组的总有效率为86.54%,优于对照组(69.81%),差异有统计学意义(P<0.05)。两组不良反应发生率差异也无统计学意义(34.62%vs.20.75%)(P>0.05)。结论丙戊酸钠缓释片联合小剂量喹硫平治疗AMDD伴NSSI患者的临床疗效优于单纯丙戊酸钠缓释片治疗,能显著改善抑郁、焦虑症状,还可降低NSSI的发生,对内分泌的影响较小,且安全性较高。
Objective To investigate the clinical efficacy of sodium valproate sustained-release tablets combined with low-dose quetiapine in the treatment of adolescent major depressive disorder(AMDD)with non-suicidal self-injury(NSSI)and its effect on serum thyroid hormone.Methods A total of 108 patients with AMDD and NSSI admitted to Wuhu Fourth People's Hospital from January 2020 to April 2022 were included in this prospective study,and then randomly divided into study group(n=54)and control group(n=54).The patients in the study group were treated with sodium valproate sustained-release tablets combined with quetiapine,and the patients in the control group were treated with sodium valproate sustained-release tablets alone for 8 weeks.The Hamilton Depression scale(HAMD-17)and Hamilton anxiety scale(HAMA),impulse scale(BIS-II),self-injury behavior screening scale,the levels of serum thyroid hormone[thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3)]before and 8 weeks after treatment,clinical efficacy,and adverse reactions during treatment were measured and compared.Results A total of 3 patients fell out in the two groups,including 2 cases in the study group and 1 case in the control group,and the scores of HAMD-17 and HAMA 8 weeks after treatment in the study group were(10.08±2.08),(9.62±2.54)pionts,respectively,which were lower than those in the control group[(12.74±1.95),(12.74±2.60)points,the differences were statistically significant(P<0.05).The total scores of BIS-11 and self-injury behavior screening scale 8 weeks after treatment in the study group were(35.45±8.90),(11.04±2.01)points,which were lower than those in the control group[(57.33±9.02),(17.16±2.19)points],the differences were statistically significant(P<0.05).There was no significant difference on serum TSH,FT3 and FT4 after 8 weeks of treatment between of the two groups(P>0.05).After 8 weeks of treatment,the clinical efficacy of the study group was 86.54%,which was better than that of the control group(69.81%),the difference was statistically significant(P<0.05).There was also no significant difference in the incidence of adverse reactions between the two groups(34.62%vs.20.75%).Conclusion The clinical efficacy of sodium valproate sustained-release tablets combined with low-dose quetiapine in the treatment of AMDD with NSSI is better than that of sodium valproate sustained-release tablets alone,it can significantly improve the symptoms of depression and anxiety,reduce the occurrence of NSSI,have little effect on endocrine and high safety.
作者
张竟艳
夏圆
施星明
徐滢
ZHANG Jing-yan;XIA Yuan;SHI Xing-ming(Department of Clinical Psychology,Wuhu Fourth People's Hospital,Wuhu Anhui 241000,China)
出处
《临床和实验医学杂志》
2022年第21期2300-2303,共4页
Journal of Clinical and Experimental Medicine
基金
安徽省医学会临床研究项目(编号:2019001268)。
关键词
丙戊酸钠
喹硫平
青少年
抑郁伴非自杀性自伤
甲状腺素
Sodium valproate
Quetiapine
Adolescents
Depression with non-suicidal self-injury
Thyroid hormone
