摘要
目的探讨氟西汀联合奥氮平治疗重度抑郁症患者的疗效。方法选取2021年10月至2023年10月达州市达川区人民医院收治的90例重度抑郁症患者的临床资料进行研究。根据治疗方法,分为对照组(n=45)和观察组(n=45),对照组采用氟西汀治疗,观察组给予氟西汀联合奥氮平治疗,时长8周,比较两组患者临床效果、临床症状评分[17项汉密尔顿抑郁量表(17-HAMD)、汉密尔顿焦虑量表(HAMA)]、血清甲状腺激素[三碘甲状腺原氨酸(T3)、甲状腺素(T4)、血清促甲状腺激素(TSH)]、神经内分泌指标[5-羟色胺(5-HT)、多巴胺(DA)和皮质醇(Cor)]及不良反应发生率的差异。结果治疗后,观察组患者的临床总有效率为93.33%(42/45)高于对照组的75.56%(34/45)(χ^(2)=5.414,P<0.05);观察组患者治疗后17-HAMD、HAMA临床症状评分[分别为(16.56±3.40)分,(15.49±2.56)分],均低于对照组[(19.67±3.58)分,(18.68±3.77)分](t=4.214,4.696,均P<0.05);观察组的T3、T4水平[(1.82±0.43)nmol·L^(-1),(90.34±10.55)nmol·L^(-1)],均高于对照组[(1.50±0.39)nmol·L^(-1),(82.45±9.62)nmol·L^(-1)](t=3.698,3.707,均P<0.05),观察组患者TSH水平[(1.87±0.74)mU·L^(-1)]低于对照组[(2.25±0.79)mU·L^(-1)](t=2.355,P=0.021);观察组的5-HT、DA水平[(40.56±7.37)μg·L^(-1),(78.34±6.55)ng·L^(-1)],均高于对照组[(31.32±6.48)μg·L^(-1),(70.45±5.60)ng·L^(-1)](t=6.316,6.142,均P<0.05),观察组Cor水平[(80.36±20.32)μg·L^(-1)]低于对照组[(97.58±21.23)μg·L^(-1)](t=3.931,P<0.05);观察组[15.56%(7/45)]和对照组[13.33%(6/45)]的不良反应发生率差异无统计学意义(χ^(2)=0.090,P>0.05)。结论针对重度抑郁症患者,氟西汀联合奥氮平治疗效果显著,能够降低患者临床症状评分,改善患者甲状腺功能和神经内分泌水平。
Objective To explore the curative efficacy of fluoxetine combined with olanzapine in treatment of patients with major depressive disorder(MDD).Methods The clinical data were collected from 90 patients with MDD admitted to Dachuan District People’s Hospital from October 2021 to October 2023.According to different treatment methods,the patients were divided into the control group(n=45,fluoxetine)and observation group(n=45,fluoxetine combined with olanzapine).All patients were treated for 8 weeks.The clinical efficacy,scores of clinical symptoms(17-item Hamilton Depression Scale(17-HAMD),Hamilton Anxiety Scale(HAMA)),serum thyroid hormones(triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH)),neuroendocrine indexes(5-hydroxytryptamine(5-HT),dopamine(DA),cortisol(Cor))and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total clinical effective rate was higher in the observation group than in the control(93.33%(42/45)vs 75.56%(34/45),χ^(2)=5.414,P<0.05).The scores of 17-HAMD and HAMA in observation group were(16.56±3.40)points and(15.49±2.56)points,which were lower than those of(19.67±3.58)points and(18.68±3.77)points in the control(t=4.214,4.696,both P<0.05).The levels of T3 and T4 in the observation group were(1.82±0.43)nmol·L^(-1) and(90.34±10.55)nmol·L^(-1),which were higher than those of(1.50±0.39)nmol·L^(-1) and(82.45±9.62)nmol·L^(-1) in the control(t=3.698,3.707,both P<0.05).However,the TSH level was lower in the observation group than in the control((1.87±0.74)mU·L^(-1) vs(2.25±0.79)mU·L^(-1);t=2.355,P=0.021).The levels of 5-HT and DA in observation group were(40.56±7.37)μg·L^(-1) and(78.34±6.55)ng·L^(-1),which were higher than those of(31.32±6.48)μg·L^(-1) and(70.45±5.60)ng·L^(-1) in the control(t=6.316,6.142,both P<0.05),while Cor level was lower than that in the control((80.36±20.32)μg·L^(-1) vs(97.58±21.23)μg·L^(-1);t=3.931,P<0.05).The difference in the incidence of adverse reactions between observation group and control group was not statistically significant(15.56%(7/45)vs 13.33%(6/45),χ^(2)=0.090,P>0.05).Conclusion Curative efficacy of fluoxetine combined with olanzapine is significant in patients with MDD since it can reduce scores of clinical symptoms as well as improve thyroid function and neuroendocrine level.
作者
王平贵
邓睿
李丹
Wang Ping-gui;Deng Rui;Li Dan(Psychiatry Department,Dazhou Dachuan District People's Hospital(Dazhou Third People's Hospital),Dazhou 635000,China;Department of Clinical Psychology,Dazhou Minkang Hospital,Dazhou 635000,China;Department of Psychosomatic Medicine,Dazhou Central Hospital,Dazhou 635000,China)
出处
《中国药物应用与监测》
CAS
2024年第5期601-604,共4页
Chinese Journal of Drug Application and Monitoring
关键词
重度抑郁症
氟西汀
奥氮平
临床疗效
临床症状评分
血清甲状腺激素
Major depressive disorder
Fluoxetine
Olanzapine
Curative efficacy
Score of clinical symptom
Serum thyroid hormone
