氟西汀合并支持性心理治疗对精神分裂症后抑郁的疗效观察

A clinical study of fluoxetine combined with supportive psychotherapy in post-schizophrenia depression

目的探讨氟西汀合并支持性心理治疗对精神分裂症后抑郁的疗效及安全性。方法将96例精神分裂症后抑郁患者随机分为氟西汀联合支持性心理治疗组(研究组)48例和支持性心理治疗组(对照组)48例。两组在保持原治疗药物不变的基础上,研究组加用氟西汀治疗。两组均于治疗前及治疗第4、8w末采用汉密顿抑郁量表、简明精神病量表评定临床疗效,采用副反应评定量表评定不良反应。结果两组治疗8w末汉密顿抑郁量表、简明精神病量表评分均较治疗前显著下降(P<0.01或0.05;汉密顿抑郁量表评分及减分率研究组较对照组下降明显,差异有显著性(P<0.05;简明精神病量表总分研究组较对照组下降明显,但差异无显著性(P>0.05)。研究组有3例出现轻度恶心、呕吐,2例出现焦虑、睡眠差,经对症处理1w内缓解。结论氟西汀治疗精神分裂症后抑郁疗效好、安全性高、服药依从性好。

Objective To explore the efficacy and safety of flouxetine combined with supportive psychotherapy in post-schizophrenia depression. Methods 96 patients were randomly divided into research (fluoxetine combined with supportive psychotherapy, n=48) and control(supportive psychotherapy, n=48) groups. Originally used drugs were retained for both the 2 groups, fluoxetine was added in research group. Efficacies and side effects were assessed with the Hamilton Depression Scale(HAMD),the Brief Psychiatric rating Scale(BPRS) and Treatment Emergent Symptom Scale(TESS) before treatment and at the ends of 4 th and 8 th week of the treatment, respectively. Results At the end of 8th week, scores of the HAMD and BPRS were significantly decreased compared with pre-treatment(P<0.01 or 0.05) in both the 2 groups; The decreases of the HAMD score and score-reducing rate were more obvious in the research than in the control group, difference was significant (P<0.05); The decrease of the BPRS total score was more obvious in the research than in the control group, difference was not significant (P>0.05).In the research group,3 patients showed mild nausea and vomiting and 2 ones did anxiety and bad sleep, after expectant treatment all those symptoms remitted. Conclusion Fluoxetine has better efficacy, higher safety and better patients' compliance in the treatment of post-schizophrenic depression.