抗抑郁药物对伴有抑郁状态癌痛患者的疗效及生活质量的影响

Effects of antidepressant drugs on the cancer pain patient with depressive state and their life quality

目的研究不同类型的抗抑郁药作为辅助性干预治疗伴有抑郁状态癌痛患者的疗效及对生活质量的影响。方法采用肿瘤患者生活质量评分、抑郁自评量表，汉密顿抑郁量表、疼痛数字分级法，将150例患者随机分成3组，全组继续应用芬太尼透皮贴剂，同时进行抗抑郁药物。A组选择盐酸文拉法莘，B组选择阿米替林，C组给予安慰剂．分别于服药当日及服药后4周进行相关各项指标的评定比较。结果治疗后A组患者抑郁情绪及生活质量有明显改善（P〈0．05），B组与C组治疗前、后差异无统计学意义（P〉0．05），疼痛评分在A、B组均有明显下降（P〈0．05）。A组未见明显的不良反应，B组不良反应较多。结论伴有抑郁状态的癌痛患者在常规应用止痛药物的同时加用抗抑郁药物非常有必要。阿米替林副反应较大不宣作为推广和首选，盐酸文拉法莘抗抑郁效果好，毒副反应小，使用安全。

Objective To investigate the effect of different antidepressant drugs on the treatmeant of cancer pain patients with depressive state and on the quality of life. Methods 150 cancer patients were divided into three groups randomly, group A..duragesic and venlafaxine; group B： duragesic and amitriptyline; group C： duragesic and placebo. Assessment of quality of life, Hamilton depression rating scale, NRS digital grading and SDS depressive measure scale were evaluated in the first day and four weeks after administrating the drugs. Results Quality of life and depression emo- tion were significantly improved after therapy in group A comparing with group B（P〈0.05）. The NRS was significantly reduced in both groups. Side-effects such as dry mouth, dysuria, constipation and so on were observed in group A while there were not in group B. Conclusion Antidepressant drugs are effective for patients with pain and depression. The venlafaxine is of less side-effects and better therapeutic effect.