舍曲林联合碳酸锂治疗双相抑郁的疗效分析

Therapeutic Effect of Sertraline Combined with Lithium Carbonate on Bipolar Depression

目的评价舍曲林联用碳酸锂治疗双相抑郁的疗效和安全性。方法将符合CCMD-3(中国精神障碍分类和诊断标准第三版)双相障碍抑郁诊断标准的86例门诊或住院患者随机分为2组,每组43例。研究组用舍曲林合并碳酸锂,对照组用阿米替林合并碳酸锂,分别治疗8 w。分别于治疗前及治疗后第2、4、6、8 w用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、不良反应量表(TESS)比较两组的疗效和安全性。结果治疗后第2、4 w末,2组HAMD、HAMA总分有显著性差异(P<0.05),研究组疗效优于对照组,第6、8 w末两组无显著性差异;治疗后第2、4、6、8 w末,2组TESS总分有显著性差异(P<0.05),研究组低于对照组;2组脱落率比较有显著性差异(P<0.05),研究组低于对照组。结论舍曲林合并碳酸锂治疗双相抑郁疗效肯定,不良反应较少,依从性好。

Objective To evaluate the therapeutic effect and safety of sertraline combined with lithium carbonate on bipolar depression.Methods A total of 86 patients with bipolar depression,diagnosed with CCMD-3（Chinese Classification of Mental Disorders,3rd Edition） were randomly divided into 2 groups.Patients in the treatment group were treated with sertraline in combination with lithium carbonate（n=43）,and patients in the control group were treated with amitriptyline in combination with lithium carbonate（n=43）.Patients were all treated for 8 w.HAMD HAMA,and TESS were used to evaluate the efficiency and safety of 2 groups before and 2,4,6,8 w after the treatment.Results The total scores of HAMD and HAMA in 2 groups were significantly different at 2,4 w after the treatment（P0.05）,and that of treatment group was better than that of control group.But the therapeutic effect had no statistically significant difference of between 2 groups at 6,8 w after the treatment（P0.05）.The total scores of TESS for patients in the treatment group were significantly lower than those of the control group at 2,4,6,8 w after the treatment（P0.05）.Conclusion The effect of sertraline combined with lithium on bipolar depression is valid and rapid,with less side effects and good adherence.