阿戈美拉汀合并认知治疗对老年抑郁症患者的效果

Efficacy of agomelatine combined with cognitive therapy in the treatment for late-life depression

目的观察阿戈美拉汀合并认知治疗对老年抑郁症患者的临床疗效。方法选取2014年4月-2015年4月就诊于天津市安定医院且符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的老年抑郁症住院患者88例为研究对象,采用随机数字表法将患者分为研究组(n=45,阿戈美拉汀合并认知治疗)和对照组(n=43,单用阿戈美拉汀治疗),两组疗程均为6周。于治疗前及治疗后第l、2、4、6周末采用汉密尔顿抑郁量表24项版(HAMD-24)、临床总体印象量表(CGI)及副反应量表(TESS)评定并比较两组的临床疗效及不良反应。结果治疗第2周末研究组和对照组HAMD-24及CGI评分与治疗前比较差异有统计学意义(P<0.01),且研究组在治疗1周末就开始起效(P<0.01);两组HAMD-24及CGI评分在治疗后第1、2、4、6周末比较研究组评分低于对照组,差异均有统计学意义(P<0.01);研究组及对照组总有效率分别为91.11%、74.42%,差异有统计学意义(P<0.05);TESS各时点评分比较两组差异无统计学意义(P>0.05)。结论与单用阿戈美拉汀相比,阿戈美拉汀联合认知心理疗法治疗老年抑郁症更有效,起效更迅速。

Objective To evaluate the efficacy and safety of agomelatine combined with cognitive therapy in the treatment oflate - life depression. Methods 88 late - life depression patients met the diagnosis of DSM - IV in Tianjin Anding Hospital in April2014 to April 2015 were randomly divided into two groups： the study group （treated with agomelatine combined with cognitive therapy,n =45） the and control group （treated with agomelatine only, n =43）. They were treated for 6 weeks. The clinical effect and adversereactions were assessed with the Hamilton Depression Scale - 24 item （ HAMD - 24 ） , Clinical General Impression （ CGI） andTreatment Emergent Symptom Scale （TESS） before the treatment and at the end of the 1st, 2nd, 4th, 6th week after treatment,and thetherapeutic effects of the two groups were compared. Results At the end of the 2nd week, scores of HAMD - 24 and CGI decreasedsignificantly in both groups （P 〈0. 01） . Therapeutic effect appeared at the end of the 1st week in study group （ P 〈 0. 01） . There weresignificant differences in scores of HAMD - 24 and CGI at the end of the 1st, 2nd, 4th, 6th week between the two groups （ P 〈 0. 01）.Scores of HAMD -24 and CGI were significantly lower in study group than control group. There was significant difference in effective rate（91.11% vs. 74.42% , P 〈0.05） , and the scores of TESS at every point had no significant difference between two groups （ P 〉 0. 05 ）.Conclusion Compared with agomelatine monotherapy, which combined with cognitive therapy has advantages with higher effective rateand fast - acting property.