戊酸雌二醇单药或联合叶酸、维生素B_(12)治疗围绝经期抑郁症的疗效比较

Estradiol Valerate Alone or in Combination with Folic Acid and Vitamin B_(12) for Perimenopausal Depression

目的比较戊酸雌二醇单药或联合叶酸、维生素B12治疗围绝经期抑郁症的临床疗效。方法将70例围绝经期抑郁症患者按治疗方法的不同分为2组:治疗组和对照组,每组35例。2组均采用戊酸雌二醇片0.5mg口服,1次·d-1,连用28d。在此基础上,治疗组采用叶酸0.4mg口服,3次·d-1;维生素B1225μg口服,3次·d-1,连用28d。观察2组临床疗效及不良反应的情况,并对2组治疗前,治疗2、4周后和随访2、4周抑郁严重程度进行评分[采用汉密尔顿抑郁量表(HAMD)评分]。结果治疗组总有效率明显高于对照组(85.7%比65.7%,P<0.05)。2组治疗2、4周后和随访2、4周HAMD得分均较治疗前明显下降(均P<0.05),治疗组治疗2、4周后和随访2、4周HAMD得分均较对照组下降更明显(P<0.05或P<0.01)。结论戊酸雌二醇联合叶酸和维生素B12治疗围绝经期抑郁症疗效优于单用戊酸雌二醇。

Objective To investigate the clinical effects of estradiol valerate alone or in combi-nation with folic acid and vitamin B12 on perimenopausal depression.Methods Seventy patients with perimenopausal depression were randomized into two groups,with 35 patients in each group. The control group was orally given estradiol valerate（0.5 mg,once per day）alone for 28 days. The treatment group was orally given combined treatment with estradiol valerate（0.5 mg,once per day）,folic acid（0.4 mg,3 times per day）and vitamin B12 （25 μg,3 times per day）for 28 days. Clinical efficacy and adverse reactions were observed in both groups.In addition,the severity of depression was assessed using the Hamilton Depression Rating Scale（HAMD）before treatment, after treatment for 2 and 4 weeks,and at the second and fourth week of follow-up.Results The total effective rate in treatment group was significantly higher than that in control group（85.7%vs 65.7%,P 〈0.05）.HAMD scores significantly decreased after treatment for 2 and 4 weeks and at the second and fourth week of follow-up in both groups,and the decrease in treatment group was more obvious than that in control group（P 〈0.05 or P 〈0.01）.Conclusion Estradiol valer-ate combined with folic acid and vitamin B12 is superior to estradiol valerate alone for treating per-imenopausal depression.