西酞普兰合用喹硫平治疗难治性抑郁症的随机对照研究

Effect of Citalopram Combined with Quetiapine in the Treatment of Refractory Depression

【目的】探讨西酞普兰合用喹硫平治疗难治性抑郁症的疗效和安全性。【方法】将符合《中国精神障碍分类与诊断标准》第三版（CCMD-3）抑郁症诊断标准的82例门诊及住院患者随机分为两组，研究组（n=42）给予西酞普兰合用喹硫平治疗，对照组（n=40）给予西酞普兰治疗，疗程12周，于治疗前和治疗后2、4、6、8、12周分别使用汉密顿抑郁量表（HAMD）、临床疗效总评量表的病情严重程度（CGI-SI）和不良反应量表（TESS）评定疗效和不良反应。【结果】治疗前研究组和对照组HAMD评分差异无统计学意义（P〉0．05）。治疗12周后，研究组和对照组的HAMD评分均低于治疗前（P〈0．05）；研究组6、8、12周HAMD评分均低于对照组（P〈0．05）；研究组有效率高于对照组（73．8％VS47．5％，P〈0．01）；治疗12周后两组CGI-SI评分比治疗前显著下降（P〈0．01，P〈0．05），治疗组下降幅度较对照组更为显著（P〈0．05）。两组间不良反应发生率差异无统计学意义（78．5％vs75％，P〉0．05）。【结论】西酞普兰合用喹硫平治疗难治性抑郁症疗效较好，安全性高。

[Objective] To explore the efficacy and safety of citalopram combined with quetiapine in the treatment of refractory depression. [Methods]Eighty-two inpatients and outpatients who met the CCMD-3 diagnostic criteria for depression were randomly divided into two groups. The research group（ n=42） received citalopram combined with quetiapine and the control group（ n = 40） received citalopram for 12 weeks. Clinical efficacy and adverse reactions were assessed with the Hanmilton depression scale（HAMD）, clinical global impression scale（CGI-SD and treatment emergent symptom scale（TESS） before treatment and at 2, 4, 6, 8 and 12 weeks after treatment. [Results] Before treatment, there were no significant differences in the scores of HAMD between the two groups （ P〉0.05）. At 12 weeks after treatment, the scores of the HAMD in both groups were lower than those before treatment（ P〈0.05）. At 6, 8 and 12 weeks after treatment, the scores of the HAMD in the research group were lower than those in the control group （ P〈0.05）. The effective rate of the research group was higher than that of the control group（73.8% vs 47.5%, P d0. 01）. At 12 weeks after treatment, the scores of CGI-SI in both groups were lower than those before the treatment（P〈0.01, P〈0.05）. There were significant differences in the scores of CGI-SI between two groups after treatment（ P〈0.05）. There was no difference in the incidence of adverse reactions between the two groups（78.5% vs 750/00, P〉0.05）. [Conclusion]Citalopram combined with quetiapine in the treatment of refractory depression has better efficacy and higher safety.