艾司西酞普兰与氟西汀治疗脑卒中后抑郁的对照研究

Controlled Study of Escitalopram and Fluoxetine in the Treatment of Post-stroke Depression

目的研究艾司西酞普兰治疗脑卒中后抑郁(Post-stroke Depression,PSD)的疗效和安全性。方法将符合(CCMD-3)抑郁发作的诊断标准的73例患者随机分为研究组和对照组,研究组口服艾司西酞普兰,对照组口服氟西汀,疗程共6周。临床疗效判定依据汉密尔顿抑郁量表(HAMD)减分率,不良反应采用不良反应量表(TESS)评定。结果研究组有效率82.35%,对照组有效率为80.56%,两组有效率比较差异无统计学意义(χ2=0.04,P>0.05)。在第2周时研究组HAMD总分低于对照组(t=2.27,P<0.05),其中睡眠障碍因子评分、焦虑/抑郁因子评分与对照组相比有显著性差异(t1=3.16,t2=6.16,P<0.01),不良反应两组之间差异无统计学意义。结论艾司西酞普兰与氟西汀治疗PSD疗效相当,不良反应少,但艾司西酞普兰起效时间比氟西汀快。

Objective To study the efficacy and safety of Escitalopram in the treatment of Post-stroke Depression（PSD）.Methods A total of 73 patients who met CCMD-3 criterion for depression episode were randomly assigned to study group and control group.Study group were given orally Escitalopram and control group were given orally Fluoxetine for 6 weeks treatment period.Clinical efficacy was evaluated using the reducing score rate of Hamilton Depression Scale（HAMD）,and adverse reactions was assessed using treatment emergent symptom scale（TESS）.Results The effective rate was 82.35% and 80.56% in study group and in control group respectively.There was no statistical difference on the effective rate between the two groups（χ2=0.04,P0.05）.But at the second week,the total score of HAMD in study group was less than that in control group（t=2.27,P0.05）,and the factor score of sleep disorders,anxiety or depression were different compared with control group（t1=3.16,t2=6.16,P0.01）,but no statistical difference exited in adverse reactions between the two groups.Conclusion There is no significant difference in the efficacy between Escitalopram and Fluoxetine in the treatment of post-stroke depression,and the adverse effects are slight.But the onset time of Escitalopram is less than Fluoxetine.