文拉法辛与氟西汀治疗脑卒中后抑郁的疗效观察

Effectivenes of fluoxetine and venlafaxine on the treatment of post-stroke depression

目的观察文拉法辛与氟西汀对脑卒中后抑郁的疗效。方法146例脑卒中后抑郁的患者随机分成两组,每组73例,分别用文拉法辛及氟西汀治疗8周。采用汉密尔顿抑郁量表(HAMD)评定疗效,对两组治疗无显著疗效者交叉换药继续治疗。结果文拉法辛组痊愈率(38.4%)高于氟西汀组(20.6%),有显著性差异(P﹤0.05);两组总显效率分别为67.2%、57.6%,无显著性差异(P﹥0.05);交叉换药的患者,文拉法辛组总显效率(48.3%)高于氟西汀组(16.5%),有显著性差异(P﹤0.05)。结论文拉法辛与氟西汀对脑卒中后抑郁总体疗效相当,前者痊愈率高于氟西汀。部分对氟西汀疗效不佳者对文拉法辛有较好的疗效。

Objective To compare the efficacy of fluoxetine and venlafaxine in post-stroke depression. Methods 146 post-stroke depression patients were randomly divided into fluoxetine treatment group and venlafaxine treatment group and all the patients were treated for 8 weeks. Hamilton depression scale （HAMD） was used to evaluate the therapeutic efficacy. The drugs crossed over between fluoxetine and venlafaxine if the patients failed to respond to the first drug. Results The effective rate of fluoxetine treatment group was higher than that of the venlafaxine treatment group（P 〈 0.05）. There was no significant difference of marked improvement rate between the two groups （P 〉 0.05）. As for the cross-over cases, the marked improvement rate of fluoxetine treatment group was higher than that of the venlafaxine （P 〈 0.05）. Conclusions Fluoxetine and venlafaxine have similar effects on post-stroke depression. However, fluoxetine is more effective than venlafaxine.