围绝经期伴发焦虑/抑郁的综合性治疗疗效观察

The Effects of a Joint Treatment on Menopausal Patients with Anxiety and Depression

目的 :本课题对综合医院妇产科医师在接受精神病学知识继续教育前后 ,治疗围绝经期伴发的焦虑 /抑郁症状的疗效与副反应进行前瞻性对照研究。方法 :研究对象为围绝经期伴发焦虑 /抑郁症状的女性病人 6 6例。主要评定工具为 RTHD、 HAMD、 HAMA、 TESS等 ,实验用药为氟西汀及雌激素尼尔雌醇、孕激素安宫黄体酮等 ;科研流程分 3阶段 :在妇产科医师接受教育前 ,按妇产科常规处理单用激素替代序贯疗法(教育前组 ) :在妇产科医师接受教育过程中 ,应用氟西汀并激素替代治疗 (教育中组 ) ;在妇产科医师接受教育后 ,应用氟西汀并激素替代治疗结合心理治疗 (教育后组 )。结果 :1.接受教育前后各组 HAMD评分的减分率显示 ,三组病人与治疗前评分的自身对照 ,均有明显好转。教育中与教育后两组间差异不明显 ,教育后与教育前组两组间差异有统计学意义 (P<0 .0 5 )。 2 .接受教育前后各组 HAMA评分的减分率显示 ,三组病人与治疗前评分的自身对照 ,均有明显好转。教育中与教育后两组间的差异不明显 ,教育后与教育前组两组间差异有统计学意义 (P<0 .0 5 )。 3.三组病人在随访过程中均未出现中度以上副反应。结论 :综合医院妇产科医师接受精神病学继续教育前后对围绝经期伴发的焦虑 /抑郁症状的处理情况不同 ,激素替代序?

Objective: To compare the effects of HRT joint Fluoxetine with HRT only in treating menopausal patients with anxiety/depressive symptom. Method: 66 Menopausal Patients who met the criteria of depression of ICD-10 co-morbid with anxiety were evaluated with HAMD, HAMA and TESS in terms of effects and side effects. All subjects were divided into three groups. The first group included 23 patients treated with HRT only, the second group included 23 patients treated with HRT joint Fluoxetine, and the third group included 20 patients treated with HRT joint Fluoxetine and psychotherapy. Results:All of the three groups showed significant improvement after 6 weeks treatment in terms of HAMD scores. There was no significant difference between the first group and the second group, the second group and the third group, meanwhile there was significant difference between the first group and the third group(P<0.05). Conclusion: All of the three projects had effects on the menopausal patients with anxiety co-morbid depression, but HRT joint Fluoxetine showed better effect, HRT joint Fluoxetine and psychotherapy together was the best.