度洛西汀和阿米替林对抑郁症患者生命质量的影响

A comparative study of efficacy on the quality of life between duloxetine and amitriptyline in treating patients with depression

目的:研究度洛西汀和阿米替林对抑郁症患者生命质量的影响,以及生命质量和疗效及药物副作用的相关性。方法:将57例抑郁症患者随机分为度洛西汀组(研究组,30例)和阿米替林组(对照组,27例),疗程6周。在基线和1、2、4、6周后,给予评定健康状况问卷(SF-36)、汉密尔顿抑郁量表(HAMD)(24项版)、汉密尔顿焦虑量表(HAMA)、治疗过程出现症状量表(TESS)。结果:治疗6周后,研究组和对照组有效率相近,分别为86.67%(26/30)、85.19%(23/27),P>0.05;痊愈率相近,分别为46.67%(14/30)、44.44%(12/27),P>0.05;对照组不良反应发生率高于研究组(77.78%vs36.67%,P<0.05);治疗6周后,研究组SF-36各因子分均高于对照组(P<0.05)。SF-36多项因子分的提高和HAMD减分率、HAMA减分率成正相关,和TESS总分成负相关(P<0.05)。结论:度洛西汀对抑郁症患者生命质量的改善优于阿米替林;抑郁症患者生命质量和焦虑、抑郁情绪的改善及药物治疗的副作用密切相关。

AIM ： To study the efficacy on the quality of life between duloxetine and amitriptyline in treating patients with depression. METHODS ： 57 patients were randomized to either duloxetine group（research group,n =30） or amitriptyline group（control group,n =27） for a 6-week period treatment.All patients were assessed with Short-Form-36 Health Survey（SF-36）,Hamilton Depression Scale（HAMD,24-items）,Hamilton Anxiety Scale（HAMA） and the Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of the 1st,2nd,4th and 6th week treatment. RESULTS ：The response rates in duloxetine and amitriptyline group were 86.67 %（26/30）and 85.19 %（23/27）respectively at the sixth weekend,the remission rates were 46.67 %（14/30）and 44.44 %（12/27）,which showed no statistical difference between the two groups（P 0.05）.Incidences of adverse reactions in amitriptyline group was significantly higher than that in duloxetine group（77.78 % vs 36.67 %,P 0.05）.At the sixth weekend,all the factor scores of SF-36 in duloxetine group were significantly higher than those in control group（P 0.05）.The improvement of the most factor scores of SF-36 after 6-week treatment was positively correlated with the decrease rates of total score of HAMD and HAMA,and negatively correlated with the total score of TESS（P 0.05）. CONCLUSION ： Duloxetine is better than amitriptyline in the improvement of quality of life in depression patients.The quality of life in depression patients is closely correlated to their depression,anxiety symptom and treatment emergent side effects.