氟西汀合用激素治疗更年期抑郁的比照研究

The treatment of menopausal depression: a placebo-controlled study

目的 探讨女性更年期抑郁治疗的疗效 ,寻求合理的治疗方案。方法 对 6 0例女性更年期抑郁患者随机分为三个治疗组 ,其中安慰剂治疗组 2 2人 ,激素替代治疗组 2 0人 ,盐酸氟西汀 +激素替代治疗组 18人 ,于治疗前和治疗后分别完成HAMD、HAMA评分。以治疗前后HAMD、HAMA的减分率统计疗效。结果 安慰剂治疗组有效率为 36 .4 % ,治愈率为 4 .5 % ;激素替代治疗组有效率为 6 0 .0 % ,治愈率为 2 5 % ;氟西汀 +激素替代治疗组有效率为 72 .2 % ,治愈率为 5 0 %。三个治疗组之间的抗抑郁疗效差异有显著性 (P <0 .0 1) ,其中盐酸氟西汀 +激素替代治疗组的抗抑郁疗效最佳 (P <0 .0 1) ,激素替代治疗的抗抑郁疗效优于安慰剂对照组 (P <0 .0 5 )。结论 盐酸氟西汀 +激素替代治疗对女性更年期抑郁疗效较好 ,对于更年期中、重度抑郁患者 ,可以推荐此治疗方案。

Objective: The purpose of this study was to explore the efficacy of treatment for menopausal depression and to seek for a reasonable protocol. Methods: 60 qualified cases were randomly divided into 3 treatment groups: placebo, hormone replacement and fluoxetine combined with hormone. The effectiveness was evaluated with HAMD and HAMA pre- and post-treatment. Results: The antidepressant effects of the three different treatment protocols differed significantly ( P <0.01), with the method of fluoxetine combined with hormone achieving the superior effect ( P <0.01), while the estrogen combined with medroxyprogesterone has the better antidepressant effect than the placebo (Geng Nian An)( P <0.05). Conclusion: The combination of fluoxetine and hormone treament has better antidepressant effect and can be suggested to be used in the moderate to severe menopausal depression.