草酸艾司西酞普兰联合奥氮平治疗老年抑郁症的效果及对睡眠质量的影响

Effect of escitalopram oxalate combined with olanzapine in the treatment of senile depression and its effect on sleep quality

目的探讨草酸艾司西酞普兰联合奥氮平治疗老年抑郁症的效果及对睡眠质量的影响。方法选取北京市朝阳区双井第二社区卫生服务中心2016年1月至2018年12月收治的62例老年抑郁症患者,随机分为观察组和对照组,每组31例。对照组在常规心理治疗基础上应用草酸艾司西酞普兰治疗,观察组在对照组的治疗基础上加用奥氮平治疗,疗程均为2个月。评价并比较两组患者的治疗效果;治疗前后,采用汉密尔顿抑郁量表(HAMD)和匹兹堡睡眠质量指数(PQSI)量表评估并比较两组患者抑郁程度和睡眠质量;观察并统计两组患者不良反应发生情况。结果观察组治疗总有效率为96.77%,高于对照组的70.97%,差异有统计学意义(P<0.05)。治疗前,两组HAMD和PQSI量表评分比较,差异无统计学意义(P>0.05);治疗后,观察组HAMD和PQSI量表评分均低于本组治疗前和同期对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率为16.13%,与对照组的9.68%比较,差异无统计学意义(P>0.05)。结论临床治疗老年抑郁症在常规心理治疗基础上采用草酸艾司西酞普兰联合奥氮平有助于进一步提高疗效,促进患者抑郁症状显著改善,提高睡眠质量,且安全性高。

Objective To investigate the effect of escitalopram oxalate combined with olanzapine in the treatment of senile depression and its impact on sleep quality.Methods Totally 62 elderly patients with depression who were admitted in Shuangjing No.2 Community Health Service Center,Chaoyang District,Beijing,from January 2016 to December 2018 were selected as subjects.They were randomly divided into two groups.In the control group,31 patients were treated with escitalopram oxalate on the basis of conventional psychotherapy,and 31 patients in the observation group were treated with olanzapine on the basis of the control group.The courses of treatment in both groups were all 2 months.Before and after treatment,the treatment effect and sleep quality of the two groups were compared and analyzed with Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PQSI).The incidence of adverse reactions in two groups were recorded.Results The total effective rate of the treatment group was 96.77%,which was significantly higher than 70.97%of the control group(P<0.05).There were no significant difference between the two groups in HAMD and PQSI scores before treatment(P>0.05).After treatment,the scores of the observation group were significantly lower than those of the control group(P<0.05).The incidence of adverse reactions was 16.13%in the observation group,and there was no significant difference compared with 9.68%in the control group(P>0.05).Conclusion Clinical treatment of senile depression on the basis of conventional psychotherapy with escitalopram oxalate combined with olanzapine may help to further improve the efficacy,promote patients with significant improvement in depressive symptoms,improve sleep quality with high safety.