度洛西汀伍用小剂量奥氮平治疗抑郁症的临床疗效和不良反应观察

Clinical efficacy and safety of duloxetine combined with small-dose olanzapine in treatment of depression

目的观察度洛西汀伍用小剂量奥氮平治疗抑郁症的临床疗效和安全性。方法 74例抑郁症患者随机分为实验组(38例)和对照组(36例),实验组患者给予度洛西汀伍用小剂量奥氮平治疗,对照组患者给予度洛西汀单药治疗,均治疗8周。汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)对治疗前及治疗后1、2、4、6、8周两组患者抑郁及焦虑症状进行评分,比较两组患者治疗前及治疗后不同时间HAMD和HAMA评分差异,并对两组患者治疗期间发生的不良反应进行比较。结果经过8周治疗,实验组有效率为81.58%,显著高于对照组的69.44%(x2=9.23,P<0.05)。治疗1、2周两组患者HAMA评分差异均有统计学意义(t=3.04,P<0.05;t=4.72,P<0.05);治疗4、6周两组患者HAMD评分差异均有统计学意义(t=2.07,P<0.05;t=7.63,P<0.05)。治疗8周后两组患者HAMD、HAMA评分均较治疗前显著降低(t=11.23,P<0.05;t=13.49,P<0.05)。此外,治疗期间两组患者均出现了体重增加、头晕、视物模糊、便秘、乏力、恶心等不良反应,但两组不良反应发生率差异无统计学意义(x2=1.03,P>0.05)。结论度洛西汀伍用小剂量奥氮平治疗抑郁症效果优于度洛西汀单药治疗,且不增加不良反应。

Objective To investigate the clinical efficacy and safety of duloxetine combined with small-dose olanzapine in treatment of depression. Methods A total of 74 depressive patients were randomly assigned into the experimental group（n=38）and control group（n=36）.Patients in the experimental group were given combined treatment with duloxetine and olanzapine for 8 weeks, while subjects in the control group were given treatment with duloxetine alone for 8 weeks.The depression and anxiety were scored using the Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）prior to treatment and 1,2,4,6 and 8 weeks post-treatment,and HAMD and HAMA scores were compared between the experimental group and the control group prior to treatment and 1,2,4,6 and 8 weeks posttreatment.In addition,the incidence of treatment-related adverse events was compared between groups. Results Following 8-week treatment, the effectiveness rate was 81.58% in the experimental group,which was significantly higher than that（69.44%）in the control group（x^2=9.23,P〈 0.05）.Significant differences were found in the HAMA score between the experimental group and the control group 1 and 2 weeks post-treatment（t=3.04,P〈 0.05;t=4.72, P〈 0.05）,and there were significant differences in the HAMA score 4 and 6 weeks post-treatment（t=2.07,P〈 0.05;t=7.63,P〈 0.05）.In addition,the HAMD and HAMA scores 8 weeks post-treatment significantly reduced as compared to those prior to treatment（t=11.23,P〈 0.05;t=13.49,P〈 0.05）.Adverse reactions occurred in both group, including increase of body weight,dizziness, blurring of vision,astriction,weakness and nausea; however,no significant difference was seen in the incidence of adverse reactions between groups（x^2=1.03,P〈 0.05）. Conclusion Our findings demonstrate higher efficacy of combined treatment of culoxetine and low dose olanzapine than duloxetine treatment alone for depression, and no increase of adverse events are seen.