帕罗西汀联合抗风湿药物治疗类风湿关节炎伴轻中度抑郁患者的临床观察

Clinical Observation of Paroxetine Combined with Anti-rheumatic Drug in the Treatment of Rheumatoid Arthritis Complicating with Mild to Moderate Depression

目的:观察帕罗西汀联合抗风湿药物治疗类风湿关节炎(RA)伴轻、中度抑郁患者的疗效和安全性。方法:将120例患者采用随机数字表法均分为试验组和对照组,两组患者常规应用抗风湿药物治疗,并给予一定的心理干预和疏导,试验组患者在此基础上于每日早晨口服帕罗西汀20 mg。两组疗程均为3个月。观察患者临床症状、体征和汉密尔顿抑郁量表(HAMD)评分的变化情况,评价其疗效,并观察不良反应情况。结果:试验组患者与对照组比较,治疗后RA临床症状、体征的差异无统计学意义(P>0.05);试验组与对照组患者治疗类风湿关节炎的总有效率分别为93.33%、76.67%,两组比较差异有统计学意义(P<0.01);治疗2、3个月后,试验组患者HAMD评分显著低于对照组(P<0.05或P<0.01);试验组与对照组患者治疗抑郁症的总有效率分别为86.67%、38.33%,两组比较差异有统计学意义(P<0.01)。两组患者不良反应均较轻微,发生率的差异无统计学意义(P>0.05)。结论:帕罗西汀联合抗风湿药物治疗RA伴轻、中度抑郁患者的疗效更加显著,抑郁症状亦显著改善,且安全性较好。

OBJECTIVE： To observe therapeutic efficacy and safety of paroxetine combined with anti-rheumatic drugs for mild to moderate depression in patients with rheumatoid arthritis. METHODS： 120 patients were randomly divided into trial group and control group. The patients in 2 groups received conventional treatment of anti-rheumatic drug, psychological intervention and coun- seling; experimental group was given paroxetine 20 mg orally every morning; treatment course lasted for 3 months. The clinical symptoms, signs and changes of HAMD score were observed, and its clinical efficacy and adverse reaction were observed and eval- uated. RESULTS： There was no statistical significance in clinical symptoms and signs of rheumatoid arthritis between experimental group and control group （P〉0.05）; the total effective rate of experimental group and control group were 93.33% and 76.67%, respectively; there was significant difference between 2 groups （P〈0.01）. HAMD of trial group was significantly lower than that of control group after 2 and 3 months of treatment （P〈0.05 or P〈0.01）. The total effective rate of depression treatment of 2 groups were 86.67% and 38.33%; there was statistical significance （P〈0.01）. Adverse drug reaction of 2 groups was mild; there was no statistical significance （P〉0.05）. CONCLUSIONS： Paroxetine combined with anti-rheumatic drugs is significantly effective for rheumatoid arthritis in patients with mild to moderate depression. Depressive symptoms are also improved significantly, and it has good safety.