度洛西汀联合认知疗法对首发抑郁症疗效的临床对照研究

A control study of cognitive therapy combined with duloxetine in the treatment of the first depressive episodes

目的探讨度洛西汀联合认知疗法对首发抑郁症的疗效和安全性。方法将80例门诊首发抑郁症患者采用数字随机法分为度洛西汀联合认知治疗组(A组,n=40)和度洛西汀组(B组,n=40)。A组以度洛西汀联合认知疗法治疗,B组单一服用度洛西汀治疗,疗程8周。采用汉密尔顿抑郁量表(HAMD-17)及副反应量表(TESS)于治疗前和治疗第2、4、6、8周末分别评定临床疗效和不良反应。结果治疗2周末两组HAMD-17评分[(17.35±5.51),(19.59±5.30)]均较治疗前下降(t=8.251、6.193,P<0.05或0.01)。在治疗2、4、6、8周末,A组HAMD-17评分均较B组低(P<0.05)。两组患者TESS量表总分差异无统计学意义(t=1.652,P>0.05)。结论度洛西汀联合认知疗法对首发抑郁症疗效可能优于单一服用度洛西汀治疗,其副反应程度相当。

Objective We explore the efficacy of cognitive therapy combining with duloxetine in the treatment of the first depressive episodes patients. Methods 80 outpatients who were diagnosed with first depressive episodes were randomly divided into two groups：Cognitive therapy group （A group, n = 40）and duloxetine group （B group, n = 40）. A group were given duloxetine combining with cognitive therapy while B group of 40 patients were given duloxetine only for the treatment. Two treatment methods both take eight weeks. The clinical effect and adverse reactions was assessed with Hamilton depression rating scale （HAMD - 17 ） and side effects scale （TESS） before the treatment and at the end of 2nd, 4th, 6th, and 8th week . Results Since at the end of the 2nd week, Hamilton depression rating scores（ 17.35 ±5.51,19, 59 ±5.30 ） of both groups is lower compared with pretreatment （t = 8.251 and 6. 193,P 〈 0.01 or P 〈 0.05 ）. In the treatment of 2, 4, 6 and 8 weekend, HAMD - 17 scores was significantly lower in the cognitive therapy group than in the duloxetine group. Two groups shown significant difference （ t = 1. 652, P 〉 0.05 ）. Conclusion The cognitive therapy combining with duloxetine treatment for first depressive episodes is superior to taking duloxe- tine only.