帕罗西汀联合奎的平治疗抑郁症对照研究

A control study of paroxetine combined with quetiapine in the treatment of depression

目的探讨帕罗西汀联合奎的平治疗抑郁症的临床疗效和安全性。方法将94例抑郁症患者随机分为两组各47例，均口服帕罗西汀治疗，研究组联合奎的平治疗。观察6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果治疗6w末，研究组显效率为89．36％，对照组为63．83％，研究组显著高于对照组（χ^2=8．545，P〈0．01）；两组治疗1w末起汉密顿抑郁量表总分均较治疗前有显著下降（P〈0．01），同期研究组均较对照组下降显著（P〈0．01）；汉密顿抑郁量表减分率均呈持续性升高，而研究组显著高于对照组（P〈0．01）；两组不良反应均轻微，多出现在治疗初期，副反应量表评分无显著性差异（P〉0．05）。结论帕罗西汀联合奎的平治疗抑郁症的临床效果显著优于单用帕罗西汀治疗，且起效快，未增加明显的药物不良反应。小剂量奎的平对抗抑郁剂治疗抑郁症具有增效作用，可作为抗抑郁剂的增效剂治疗抑郁症。

Objective To explore the efficacy and safety of paroxetine combined with quetiapine in the treatment of depression. Methods 94 depression patients were randomly assigned to two groups, both groups took orally paroxetine and research group was plus quetiapine for 6 weeks. Efficacies were assessed with the Hamilton Depression Scale（HAMD） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 1^st ,2^nd ,4^th and 6^th week treatment. Results At the end of the 6^th week, obvious effective rates were respectively 89.36% in the research and 63.83% in the control group, the former was significantly higher than the latter（χ^2=8. 545,P〈0.01 ）;Since the end of the 1^st week,the total scores of the HAMD of both groups lowered more significantly compared with pretreatment（P〈0.01） ,so did in the research than in the control group in the corresponding time period（P〈 0.01） ; score-decrement rates of the HAMD of both groups heightened continously and that did more significantly in the research than in the control group（P〈0.01） ; adverse reactions of both groups were mild and took place in the initial stage of-treatment mostly, and there was no significant difference in the TESS score（P〉0.05）. Conclusion Paroxetine combined with quetiapine has more notable efficacy and takes effects faster than single paroxetine and doesn＇t increase evident adverse reactions in the treatment of depression. Small dose quetiapine has a synergism to antidepressant treating depression and can be used as synergist of antidepressants in the treatment of depression.