喹硫平、阿立哌唑联合文拉法辛治疗难治性抑郁症的对照研究

Therapeutic Effect of Quetiapine,Aripiprazole Combined Venlafaxine on Treatment-refractory Depression

目的探讨非典型抗精神病药喹硫平、阿立哌唑合并抗抑郁药文拉法辛治疗难治性抑郁症的疗效和不良反应。方法将78例难治性抑郁症患者随机分为喹硫平组(n=27)、阿立哌唑组(n=26)和对照组(n=25),在均使用文拉法辛治疗的同时喹硫平组和阿立哌唑组,分别合并小剂量喹硫平和阿立哌唑治疗8周。采用汉密尔顿抑郁量表(HAMD)、汉米尔顿焦虑量表(HAMA),在治疗前及治疗1、2、4、8周各测定1次;并在治疗前及治疗8周测血常规、肝功能、体重及副反应评定量表(TESS)。结果喹硫平组和阿立哌唑组在治疗第2周末开始HAMD(F=6.918,P<0.01)、HAMA(F=4.782,P<0.05)评分显著低于对照组。经过8周治疗,喹硫平组(78%)和阿立哌唑组(73%)的显效率显著好于对照组(χ2=9.416,P<0.01)。3组患者治疗过程中出现的不良反应均为轻度可控。结论喹硫平和阿立哌唑合并文拉法新治疗难治性抑郁症有增效作用,疗效好、见效快、安全性高。

Objective To explore the efficacy and side elect of quetiapine,aripiprazole combined venlafaxine on treatment-refractory depression. Methode A total of 78 cases of treatment-refractory depression were randomly assigned to quetiapine group （n= 27）, aripiprazole group （n= 26） and the control group （n=25）. All cases used venlafaxine as antidepressants, and respectively, small-dose quetiapine, aripiprazole were used as a synergist for 8 weeks＇ treatment. Hamilton Depression Rating Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were tested before treatment and after 1,2,4,8 weeks of treatment;before treatment and after 8 weeks＇ treatment, the blood test routine, liver function, body weight and Side Effects Rating Scale （TESS） were used. Re suits The HAMD（F = 6. 918, P〈 0. 01） and HAMA （F = 4. 782, P〈 0. 05 ） scores of quetiapine group and aripiprazole group were significantly lower than the control group after the treatment of first 2 week. After 8 weeks of treatment, the markedly ef- fective rate of quetiapine group （78 % ）, aripiprazole group （73 % ） were significantly better than the control group （X^2= 9. 416, P 〈0. 01）. The adverse events of three groups during the treatment were mild controllable. Conclusion It is demonstrated that Quetiapine,Aripiprazole combined venlafaxine have synergjistiz effect on the treatment-refractory depression with fast onset of action,safe and few side effect.