西酞普兰联合认知疗法治疗抑郁症对照研究

A control study of citalopram combined with cognitive therapy in the treatment of depression

目的 探讨西酞普兰联合认知疗法治疗抑郁症的临床疗效和安全性.方法 将96例抑郁症患者随机分为两组,每组48例,两组均口服西酞普兰治疗,在此基础上研究组联合认知疗法治疗.观察8周.于治疗前及治疗2周、4周、8周末采用汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应.出院后随访1 a,统计复发率.结果 治疗后两组汉密顿抑郁量表总分均较治疗前显著下降（P＜0.01）,研究组治疗4周、8周末均较对照组下降更显著（P＜0.05）;治疗8周末,研究组有效率为95.8%,对照组为83.3%,研究组显著高于对照组（χ2=4.06,P＜0.05）.治疗后两组不良反应均轻微,研究组发生率为25.0%,对照组为27.1%,两组差异无显著性（P＞0.05）.随访1 a末研究组复发率为14.6%,对照组为33.3%,研究组复发率显著低于对照组（χ2=3.86,P＜0.05）.结论 西酞普兰联合认知治疗能显著提高抑郁症的临床疗效,远期效果更显著,能有效预防复发,且安全性高,依从性好,显著优于单用西酞普兰治疗.

Objective To explore the efficacy of citalopram combined with cognitive therapy in the treatment of depression. Methods Ninety depression patients were randomly divided into two groups of 48 ones each, both groups took orally citalopram and research group was plus cognitive therapy for 8 weeks. Efficacies were assessed with the Hamilton Depression Scale （HAMD） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） at baseline and at the end of the 2^na ,4^th and 8^th week. They were followed up for I year after discharge and relapse rates added up. Results After treatment, the H AMD total scores of both groups lowered more significantly compared with pretreatment （P〈0.01）, and so did those at the end of the 4^th and 8^th week in research than control group （P〈0. 05） ; at the end of the 8^th week, effective rates were respectively 95.8% in research and 83.3% in control group, the former was significantly higher than the latter （X^2=4.06,P〈0.05）. After treatment, adverse reactions of both groups were mild, incidences of adverse reactions were respectively 25.0% in research and 27.1% in control group, which showed no significant difference （P〈0.05）. Relapse rate was respectively 14.6% in research and 33.3%, the former was significantly lower than the latter （X^2=3.86,P〈0.05）. Conclusion Citalopram combined with cognitive therapy can improve the curative effect in the treatment of depression notably, long-term efficacy is more notable, can effectively prevent relapse, has higher safety, better compliance and an advantage over single citalopram.