内观疗法对抑郁症残留症状疗效随机对照研究

A randomized controlled study of Naikan therapy efficacy on the residual symptoms of depression

目的探讨文拉法辛合并内观疗法治疗抑郁症残留症状的疗效。方法 60例心境障碍-抑郁发作患者单用文拉法辛治疗6周后,汉密顿抑郁量表(Hamilton Depression Scale-17,HAMD-17)评分为7分≤HAMD-17<17分,随机分为研究组(n=30)和对照组(n=30),分别给予为期4周的文拉法辛合并内观疗法治疗和单用文拉法辛治疗。在基线期和4周末采用HAMD-17、临床总体印象量表(clinical global impression,CGI)、生活满意度量表(life satisfactionrating scale,LSR)评定疗效。结果基线期研究组和对照组HAMD-17、CGI、LSR评分差异无统计学意义(P>0.05);治疗4周末,研究组HAMD-17减分显著高于对照组,差异有统计学意义(P<0.05);研究组CGI-S减分显著高于对照组,差异有高度统计学意义(P<0.01),研究组CGI-I减分显著低于对照组,差异有高度统计学意义(P<0.01);治疗4周后研究组LSR各项因子分及总分增分显著高于对照组,差异有统计学意义(P<0.05或P<0.01)。结论文拉法辛合并内观疗法较单用文拉法辛能更好的缓解心境障碍-抑郁发作患者的残留症状,提高患者的生活满意度。

Objective To investigate the efficacy of Venlafaxine combined with Naikan therapy in the treatment of residual symptoms of depression. Methods 60 patients with major depression were treated with Venlafaxine for 6 weeks, and the grade of HAMD-17 was 7 scores ≤HAMD-17〈17 scores. Patients were randomly divided into the study group and the control group, who were treated with Venlafaxine combined with Naikan therapy and single Venlafaxine for 4 weeks re- spectively. At the baseline and the end of fourth week of treatment, Hamilton depression scale-17 （HAMD-17）, clinical global impression （CGI）, life satisfaction rating scale （LSR） were employed to evaluated the clinical efficacy. Results There were no significant differences in HAMD-17, CGI and LSR score between the two groups at the baseline （P 〉 0.05）. At the end of the 4th week of treatment, HAMD-17 reduced score of the study group was significantly higher than the control group （P 〈 0.05）; CGI-S reduced score of the study group was significantly higher than the control group （P 〈 0.01） and CGI-I reduced score of the study group were significantly lower than the control group （P 〈 0.01）; LSR factors and total in- creased score of the study group were significantly higher than the control group （P 〈 0.05 or P 〈 0.01 ）. Conclusion Compared with single use of Venlafaxine, Venlafaxine combined with Naikan therapy may have better effect in the treat- ment of residual symptoms of depression and may have better improvement of the life satisfaction.