氟西汀对抑郁症患者精力异常的临床疗效评价

Effects of fluoxetine on changes of energy in patients with depression

目的 :为了研究氟西汀是否能有效缓解与抑郁相关的精力异常。方法 :对 5 5例抑郁症患者进行对照观察 ,氟西汀组 2 9例 ,予以氟西汀 2 0mg ,po ,qd ;阿米替林组 2 6例 ,予以阿米替林 75mg ,po ,bid ;6周为一疗程。以HAMD迟滞因子评分为依据 ,将患者按基线评分水平划分为低迟滞亚组 (HAMD评分 <8)和高迟滞亚组 (HAMD评分≥ 8)。采用HAMD迟滞因子评分 (第 1项 :情绪低落、第 7项 :工作和活动、第 8项 :迟滞、第 14项 :生殖器症状、第 13项 :躯体症状 一般状况 )以及SCL 5 8中有关精力项目 (第 14项 :感觉精力不足、第 32项 :感觉对事物没有兴趣、第 5 5项 :专注于自己所遇到的困难 )来衡量精力的改变。结果 :2组治疗后 6周 ,HAMD总分、迟滞因子个条目以及SCL 5 8中有关精力项目评分均显著下降 ,而氟西汀组下降较阿米替林组更为明显 ,且在治疗 1、2周末即有显著性差异 (P <0 .0 5 )。氟西汀组中高迟滞与低迟滞 2亚组疗效相当 (P >0 .0 5 ) ,而阿米替林组中高迟滞亚组疗效较低迟滞亚组差 (P <0 .0 5 ) ;与阿米替林组相比 ,高迟滞亚组接受氟西汀治疗效果更佳 (P <0 .0 5 )。结论 :氟西汀能早期有效改善抑郁症的精力症状 ,提示临床上对HAMD迟滞因子分高的病人较阿米替林等具明显镇静作用的药物更为适合。

AIM: To investigate the effects of fluoxetine on the changes o f depression-related disturbances in energy. METHODS: 55 patien ts with depression were randomly assigned to two groups: fluoxetine group (n=29) treated with 20 mg·d -1 fluoxetine, po, qd, and amitr iptyline group (n=26) treated with 150 mg·d -1 amitrip tyline, po, bid. Two groups were observed for 6 weeks. According to the Hamilton Rating Scale for Depression (H AMD) retardation factor score, t hese patients were categorized as low (score<8) or high (score> or=8) levels of retardation at baseline. HAMD retardation factor score (total of items 1: depres sed mood, 7: work and activity, 8: retardation, 13: somatic/general symptoms and 14: urogenital symptoms) and Hopkins Symptom Checklist 58 (HSCL-58) energy-re lated items (including item 14: feeling low in energy or slowed down, 32: feelin g no interest in things, 55: absorption in the difficulty) was used as the prima ry measure of the improvement of energy. RESULTS: 6 weeks after treatment, HAMD total scores, retardation factor score and SCL-58 energe-relat ed items scores decreased more significantly in fluoxetine group than that in am itriptylined group (P< 0.05) after 1-2 weeks treatment. No si gnificant difference of efficacy was found between high and low level of retarda tion in fluoxetine group, but the efficacy of high levels of retardation was les s than that of low levels (P<0.05) in amitriptyline group. Compa red to amitriptyline-treated subgroup, the efficacy level of fluoxetine-treate d high levels of retardation subgroup was higher (P< 0.05). CONCLUSION: Fluoxetine can significantly improve the depression -related disturbances in energy, and it is more suitable for the patients with the higher levels of HAMD retardation factor score.