盐酸舍曲林与阿米替林治疗帕金森病后抑郁症的比较研究

A comparative study of sertraline and amitriptyline in the treatment of depressive disorders following Parkinson's disease

目的探讨盐酸舍曲林与阿米替林治疗帕金森病后抑郁症的疗效与安全性。方法 80例帕金森病后抑郁症患者随机分为盐酸舍曲林组与阿米替林组各40例,采用汉密尔顿抑郁量表(HAMD)评估临床疗效,抗抑郁药不良反应量表(SERS)评估其安全性,以不良反应频数评估其不良反应程度。分别于治疗后1、2、4和8周观察其HAMD评分及SERS评分,治疗8周末统计其不良反应出现频数。结果两组HAMD总分于1、2、4和8周末均低于治疗前,1、2周时阿米替林组明显优于盐酸舍曲林组,4周时两组之间无明显差异,8周时盐酸舍曲林组明显优于阿米替林组。两组SERS总分于1、2、4和8周时盐酸舍曲林组评分均低于阿米替林组。盐酸舍曲林常见的不良反应有口干、便秘、头痛、嗜睡、夜尿、体重增加、恶心呕吐、体重增加等。阿米替林常见的不良反应有食欲减退、排尿困难、视物模糊、心悸、便秘、嗜睡、口干等。结论阿米替林起效较快,盐酸舍曲林在治疗帕金森病后抑郁症的远期效果较好,不良反应相对较少。

Objective To investigate the efficacy and safety of sertraline and amitriptyline in the treatment of depressive disorders following Parkinson＇s disease. Methods The 80 patients with depressive disorders following Parkinson＇s disease were randomly divided into Sertraline group and Amitriptyline group. Hamilton depression scale（HAMD） and side effects rating scale（SERS） were used to evaluate the efficacy and the safety,one two,four and eight weeks after treatment,respectively. And adverse reaction frequency was evaluated by using SERS scale after eight weeks. Results The HAMD of two groups were decreased compared with that before treatment,the Amitriptyline group was significantly decreased compared with Sertraline group one and two weeks after treatment. There were no significant differences between two groups after four weeks. And the Sertraline group was significantly decreased compared with Amitriptyline group after eight weeks;The SERS of Sertraline group was decreased compared with Amitriptyline group. The common adverse reactions of sertraline were dry mouth,constipation,headache,drowsiness,nocturia,high weight,nausea and vomiting,etc.. The common adverse reactions of amitriptyline were loss of appetite,difficulty in urination,depending on the material fuzzy,heart palpitations,constipation,drowsiness,dry mouth,etc.. Conclusion The efficacy of amitriptyline is of early enset,but the long-term efficacy of sertraline is better and its adverse reactions are less in the treatment of depressive disorders following Parkinson＇s disease.