艾司西酞普兰与氟西汀治疗抑郁症患者的临床观察

Clinical Observation of Escitalopram and Fluoxetine in the Treatment of Depression

目的：观察艾司西酞普兰与氟西汀治疗抑郁症患者的疗效及安全性。方法：将106例抑郁症患者按随机数字表法分为观察组和对照组,各53例。观察组患者给予艾司西酞普兰10~20 mg,qd;对照组患者给予氟西汀20~40 mg,qd。两组患者均治疗6周。观察两组患者临床疗效及治疗前后白细胞介素（IL）-2、IL-6、肿瘤坏死因子α（TNF-α）、血清同型半胱氨酸（Hcy）水平,并记录治疗前后汉密顿抑郁量表（HAMD）评分及副反应量表（TESS）评分。结果：观察组患者总有效率（86.79%）与对照组（77.36%）比较,差异无统计学意义（P〉0.05）;治疗后,两组患者血清IL-2、IL-6、TNF-α、Hcy水平明显降低,且观察组明显低于对照组,差异有统计学意义（P〈0.05）。治疗后,两组患者情绪、精神性焦虑、睡眠障碍、认知障碍、躯体性焦虑评分及HAMD总分均显著下降,且观察组明显低于对照组,差异有统计学意义（P〈0.05）。治疗后3、6周,观察组患者TESS评分均明显低于对照组,差异有统计学意义（P〈0.05）。结论：艾司西酞普兰与氟西汀治疗抑郁症患者疗效相当,但艾司西酞普能明显改善患者炎性反应,降低Hcy水平,且不良反应较轻。

OBJECTIVE：To observe therapeutic efficacy and safety of escitalopram and fluoxetine in the treatment of depression. METHODS：106 patients with depression were randomly divided into observation group and control group with 53 cases in each group. Observation group was given escitalopram 10-20 mg,qd,and control group was given 20-40 mg,qd. Both groups were treated with 6 weeks. The levels of IL-2,IL-6,TNF-α and Hcy were observed in 2 groups,and HAMD and TESS were recorded in 2 groups. RESULTS：Total effective rate of observation group（86.79%） was higher than that of control group（77.36%）,with statistical significance（P〉0.05）;after treatment,the levels of IL-2,IL-6,TNF-α and Hcy decreased significantly in 2 groups,the observation group was lower than the control group,with statistical significance（P〈0.05）. After treatment,emotion,mental anxiety,sleep disorder,cognitive disorder,somatic anxiety score and HAMD total score all decreased significantly in 2 groups,the observation group was significantly lower than the control group,with statistical significance（P〈0.05）. TESS score of observation group was significantly lower than that of control group 3 weeks and 6 weeks after treatment,with statistical significance（P〈0.05）. CONCLUSIONS：Escitalopram is similar to fluoxetine in the treatment of depression,but escitalopram can improve inflammatory response significantly and decrease the level of Hcy with mild ADR.