选择性5-HT再摄取抑制剂与5-HT、NE再摄取双重抑制剂治疗围绝经期情绪障碍疗效

Contrast of Clinical Effects between SSRIS and SNRIs on the Treatment of Perimenopausal Mood Disorders

目的观察选择性5-HT再摄取抑制剂(SSRIs)与5-HT、NE再摄取双重抑制剂(SNRIs)治疗围绝经期情绪障碍的临床疗效。方法选择我院门诊就诊的围绝经期情绪障碍患者40例作为入组对象,随机分为SSRIs组和SNRIs组,疗程12周,自入组、治疗2、4、6、8、12周使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)对两组患者症状进行组间、组内比较。结果与入组的比较治疗2、4、6、8、12周两组患者的情绪障碍均得到持续改善:SSRIs组HAMD躯体症状(t=2.05,2.82,3.28,6.60,10.34;P<0.05或0.01),心境症状(t=2.03,2.14,3.38,5.05,8.96;P<0.05或0.01);SSRIs组HAMA躯体症状(t=2.12,2.47,3.31,6.21,8.86;P<0.05或0.01),心境症状(t=2.03,2.38,3.38,6.24,7.08;P<0.05或0.01),SNRIs组HAMD躯体症状(t=3.92,4.68,5.67,7.22,10.94;P<0.01),心境症状(t=3.55,5.42,7.41,9.14,12.31;P<0.01),SNRIs组HAMA躯体症状(t=4.42,5.57,7.00,10.43,13.06;P<0.01),心境症状(t=2.81,3.12,5.32,6.86,23.40;P<0.01);治疗各周SNRI组HAMD躯体症状(t=2.76,2.71,2.44,6.15,18.00;P<0.05或0.01),心境症状(t=2.06,2.15,3.14,5.35,7.22,10.75;P<0.05或0.01),HAMA躯体症状(t=3.04,3.63,4.70,4.28,9.26;P<0.01),心境症状(t=2.81,3.12,5.32,6.86,23.40;P<0.01)改善程度明显优于SSRI治疗组。结论 SSRIs与SNRIs药物均能显著改善围绝经期患者的情绪障碍,两者比较SNRIs药物整体疗效明显优于SSRIs药物。

Objective To contrast clinical effects between SSRIS and SNRIs on the treatment of perimenopausal mood disorders.Methods To select randomly 40 patients with perimenopausal mood disorders who were outpatients and divided into SSRIS and SNRIs groups for 12 weeks. To evaluate clinical effects of two groups by HAMD and HAMA and contrast each factors within and between groups. Results There were significant improvement of mood disorders in two groups at each week： SSRIs HAMD physical symptoms（ t= 2. 05,2. 82,3. 28,6. 60,10. 34; P 0. 05）,mood symptoms（ t = 2. 03,2. 14,3. 38,5. 05,8. 96; P 0. 05）; SSRIs HAMA physical symptoms（ t = 2. 12,2. 47,3. 31,6. 21,8. 86; P 0. 05）,mood symptoms（ t = 2. 03,2. 38,3. 38,6. 24,7. 08; P 0. 05）,SNRIs HAMD physical symptoms（ t = 3. 92,4. 68,5. 67,7. 22,10. 94; P 0. 01）,mood symptoms（ t = 3. 55,5. 42,7. 41,9. 14,12. 31; P 0. 01）,SNRIs HAMA physical symptoms（ t = 4. 42,5. 57,7. 00,10. 43,13. 06; P 0. 01）,mood symptoms（ t = 2. 81,3. 12,5. 32,6. 86,23. 40;P 0. 01）; Physical symptoms（ t = 2. 76,2. 71,2. 44,6. 15,18. 00; P 0. 05）（ t = 3. 04,3. 63,4. 70,4. 28,9. 26; P 0. 01） and mood symptoms（ t = 2. 06,2. 15,3. 14,5. 35,7. 22,10. 75; P 0. 05）（ t = 2. 81,3. 12,5. 32,6. 86,23. 40; P 0. 01） of HAMD and HAMA in SNRI group were superior to SSRI group. Conclusion SSRIS and SNRIs can both improve significantly perimenopausal mood disorders.The overall effect of SNRIs is superior to SSRIs.