小剂量短程奥氮平联合氟西汀治疗老年卒中后抑郁的研究

The Therapeutic Alliance Effect of Low Dose and Short-range Olanzapine and Fluoxetine in Aged Post Stroke Depression(PSD) Patients

目的评价小剂量短程奥氮平联合氟西汀治疗老年卒中后抑郁的疗效。方法 72例老年卒中后抑郁患者随机分为两组,每天均给予氟西汀20mg,连续6周,其中治疗组34例早期每晚合用奥氮平2.5～5mg,连续2周。于治疗前后采用汉密尔顿抑郁量表(HAMD)评定临床疗效,采用不良反应量表(TESS)评价其安全性。结果治疗组在治疗后3d、1周、2周、4周、6周时HAMD评分改善的总有效率分别为30.6%、47.8%、76.2%、84.4%和84.6%,而对照组分别为5.8%、18.6%、35.6%、61.2%和79.4%,两组总有效率在治疗3d、1周及2周时差别有显著性(P<0.05)。结论单用氟西汀治疗老年卒中后抑郁起效慢且疗效较低,合并使用小剂量短程奥氮平起效快疗效高,且不增加不良反应。

Objective To evaluate the therapeutic alliance effect of low dose,short-range Olanzapine and fluoxetine in aged post stroke depression（PSD） patients.Methods A total of 72 cases were divided to two groups.All patients took fluoxetine at 20mg/d for 6 weeks.34 patients combined with 2.5~5mg/d Olanzapine in earlier treatment for 2 weeks.To evaluate the clinical theurapeutic effect and side effective with Hamilton Depression Scale（HAMD） and Treatment Emergent Symptom Scale（TESS）individually before and after treatment.Result The improvement percentage of treatment group is 30.6%,47.8%,76.2%,84.4% and 84.6% in 3 days and 1,2,4,6 week individual.But control group is 5.8%,18.6%,35.6%,61.2% and 79.4%.There is a significant difference between two groups（P0.05） in 1 day and 1,2 week.Conclusion Fluoxetine reveal poor and slower therapeutic effective administered singly in aged post stroke depression（PSD） patients.Treating alliance with low dose,short-range Olanzapine improve therapeutic effective faster,and not to increase side effect.