帕罗西汀治疗2型糖尿病并发焦虑抑郁症的临床观察

Clinical review of paroxetine in type 2 diabetes mellitus patients with anxiety and depression

目的探讨帕罗西汀对2型糖尿病并发焦虑抑郁症患者的疗效及其糖代谢的影响。方法 66例2型糖尿病并发焦虑抑郁症的患者随机分为对照组和帕罗西汀组。对照组维持原治疗方案,不应用抗焦虑抑郁剂;帕罗西汀组在维持原糖尿病治疗方案的基础上加用帕罗西汀每日一次,每次20 mg,疗程为8周。采用焦虑自评量表(SAS),抑郁自评量表(SDS),评定焦虑抑郁症症状改善情况。检测空腹血糖(FBG),餐后两小时血糖(2 hPBG)和糖化血红蛋白(HbA1c),评价糖代谢情况。结果治疗8周后焦虑自评量表,两组抑郁自评量表评分均较治疗前显著下降(P<0.05),研究组较对照组下降更明显(P<0.05)。8周后FBG、2hPBG HbA1c测评,两组之间的比较差异均有统计学意义(P<0.05)。结论 2型糖尿病并发焦虑抑郁症患者服用帕罗西汀8周后其抑郁症状得到明显缓解,糖代谢紊乱状况也得到显著改善。

Objective This survey aims to investigate the efficacy of paroxetine on the levels of depression - anxiety, glycemic control in type 2 diabetes mellitus patients. Methods We randomized 66 depressed diabetic patients with non - optimally controlled diabetes to an 8 - week double - blind treatment with either paroxetine 20 mg per day or matching placebo. Psychiatric symptoms were assessed with the Hospital Anxiety and Depression Scale. The fasting blood glucose （ FBG）, 2 - hour post - prandial blood glucose （2 h PBG） contents and glycosylated haemoglobin （HbA1 c） were detected to evaluate the glycemic contrl. Results Both groups showed a statistically significant decrease in SAS and SDS scores with comparison to the index assessment （ P 〈0.05 ）. Statistically significant difference was also observed on the level of FBG and 2 h PBG in both groups after 8 weeks （ P 〈0.05）. The more dramatic decreasing of SAS and SDS scores was found in the treatment group than the other one （ P 〈 0.05 ）. Conclusion After 8 - week therapy of Paroxetine, the severe depressive disorder and the glycemic control in type 2 DM patients were effectively alleviated and improved.