小剂量阿米舒必利合并西酞普兰治疗老年期抑郁症的对照研究

Control study of effect of low dose amisulpride combined with citalopram on senile depression

目的探讨小剂量阿米舒必利对老年期抑郁症的辅助治疗作用。方法采用随机开放对照研究,将60例诊断为老年期抑郁症的患者随机分为研究组(阿米舒必利联合西酞普兰治疗组)与对照组(单纯西酞普兰治疗组),分别在治疗前及治疗后第2、4、6、8周末,予汉密尔顿抑郁量表(HAMD)、临床疗效总评价量表中的疗效总评价项目(CGI-GI)评定疗效,同时采用Asberg抗抑郁剂副反应量表(SERS)评定两组的药物不良反应。结果治疗后第2、4、6、8周末,研究组HAMD评分低于治疗前(P<0.05,P<0.01);治疗后第8周末,对照组HAMD评分低于治疗前(P<0.01)。治疗后第2、4、6、8周末,研究组HAMD评分低于对照组(P<0.05,P<0.01)。治疗后第4、6、8周末,研究组CGI-GI总分低于治疗前(P<0.05,P<0.01);治疗后第8周末,对照组CGI-GI总分低于治疗前(P<0.01)。治疗后第4、6、8周末研究组CGI-GI总分低于对照组(P<0.05,P<0.01)。研究组显效率77%,总有效率90%,对照组显效率53%,总有效率77%。研究组显效率及总有效率明显高于对照组(χ21=56.00,χ22=103.15,P<0.01)。结论小剂量阿米舒必利联合西酞普兰治疗老年期抑郁症疗效明显优于单一应用西肽普兰治疗。

Objective To study the efficacy of low dose amisulpride as adjunctive therapy in the treatment of senile depression. Methods 60 patients with senile depression were randomized into study group （30 cases） treated with low dose amisulpride combined with citalopram and control group （30 cases） treated with eitalopram monotherapy for 8 weeks. All patients were assessed with Hamilton Depression Scale （HAMD） and Clinical Global Impression-Global Improvement （CGI-GI） to evaluate the efficacy, and was assessed with Asberg Rating Scale for Side Effects （SERS） to evaluate the side reactions at baseline and at the end of the 2nd, 4th, 6th, 8th week of the treatment. Results Compared with baseline, score of HAMD in study group decreased significantly at the end of the 2nd, 4th, 6th, 8th week （P 〈 0.01 or P 〈 0.05 ） , while the significant decrease appeared till at the end of the 8th week of the treatment （P 〈 0.01 ）. Scores of HAMD in study group was significantly lower than those in control group at the end of the 2nd, 4th, 6th, 8th week （P 〈0.01 or P 〈0.05）. At the end of the 4th, 6th, 8th week, scores of CGI-GI in study group was significantly lower than baseline （P 〈 0.01 or P 〈 0.05 ）. While till at the end of the 8th week of the treatment, score of CGI-GI in control group was significantly lower than that at baseline （P 〈 0.01 ）. Scores of CGI-GI in study group were significantly lower than those in control group at the end of the 4th, 6th, 8th week （P 〈0.01 or P 〈0.05）. The marked effective rate was 77% in study group and 53% in control group, and the total effective rate was 90% in study group and 77% in control group. The marked effective rate and total effective rate in study group were significantly higher than those in control group （ P 〈 0.01 ）. Conclusion Low dose amisulpride combined with citalopram has better efficacy than citalopram monotherapy in the treatment of senile depression.