度洛西汀合并齐拉西酮治疗难治性抑郁症的临床研究

THE EFFECTS OF DULOXETINE WITH SMALL-DOSE ZIPRASIDONE IN THE TREATMENT OF DEPRESSION

目的观察度洛西汀合并小剂量齐拉西酮(剂量在80 mg/d以下)治疗抑郁症的临床疗效。方法 80例抑郁症患者随机分成两组,研究组采用度洛西汀合用齐拉西酮治疗,对照组单用度洛西汀治疗。共观察8周,于治疗前,治疗后1、2、4、6、8周末采用汉密尔顿抑郁量表(HAMD),副反应量表(TESS)评定疗效及不良反应,并随访1年,观察其1年内的复发率。结果研究组与对照组的显效率分别为89.2%和70.3%,两组比较有显著性差异(P<0.05);两组治疗后1、2、4、8周HAMD、HAMA评分差异有显著性(P<0.05);两组的HAMD、HAMA因子分在焦虑/躯体化和睡眠障碍方面差异有显著性(P<0.05);TESS评分及1年内复发率无明显差异(P>0.05)。结论度洛西汀合用小剂量齐拉西酮治疗抑郁症起效快,克服了抗抑郁药本身起效慢的特点,可提高疗效,并能迅速改善睡眠障碍和焦虑/躯体化症状,对复发率无明显影响。

Objective To study the clinical effects of duloxetine with smalldose ziprasidone （〈 80mg/d） in the treatment of depression. Methods 80 hospitalized patients who met CCMD - 3 criteria of depression were randomly divided into the research group treated with duloxetine and ziprasidoneand and the control group treat- ed with duloxetine for 8 weeks. The efficacy and side effects were evaluated with HAMD and TESS at the end of the 1st ,2nd, 4th , 6th and 8th week. One - year follow - up surveys were conducted. Results The treatment with paroxetine and ziprasidone produced better clinical results in the research group than in the control group in terms of stress and dyssomnia according to HAMD and HAMA （ P 〈 0.05 ）. No significant differences were found in curbing recurrence between the two groups（ P 〉0.05）. Conclusion Duloxetine with small- dose ziprasidone can effectively relieve stress and and discomfort, but producingl no obvious effects on recurrence.