艾司西酞普兰联合奥氮平治疗难治性抑郁症的临床疗效

The Clinical Efficacy of Escitalopram Combined with Olanzapine in the Treatment of Refractory Depression

目的 探讨艾司西酞普兰联合奥氮平治疗难治性抑郁症患者的临床疗效。方法 选取2013年1月至2015年5月于临沂市精神卫生中心心理科门诊就诊的难治性抑郁症患者96例,将其按抽签法分成对照组和观察组,各48例。对照组患者给予艾司西酞普兰10~20 mg,早餐后1次,口服;观察组患者在此基础上给予奥氮平5.0~7.5 mg,口服,晚餐后1次,口服,总疗程12周。比较两组患者治疗前及治疗后汉密尔顿抑郁量表（HAMD）评分及汉密尔顿睡眠障碍因子评分。结果 观察组患者治疗后总有效率显著高于对照组[81.25%（39/48）比52.08%（25/48）],差异有统计学意义（P〈0.05）。两组疗效比较差异有统计学意义（P〈0.05）。两组HAMD评分治疗2、4、8、12周后均较治疗前呈下降趋势,且观察组下降速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义（P〈0.05）。两组主观睡眠障碍因子评分治疗后2、4、8、12周均较治疗前呈下降趋势,且观察组下降速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义（P〈0.05）。观察组患者体质量增加率显著高于对照组（P〈0.05）。结论 艾司西酞普兰联合奥氮平治疗难治性抑郁症患者可以快速有效缓解患者抑郁症状,改善患者睡眠质量,值得临床推广。

Objective To analyze the clinical efficacy of escitalopram combined olanzapine in treatment of refractory depression. Methods From Jan. 2013 to May 2015 96 patients with refractory depression in Linyi City Center offor Mental Health were included in the study and divided into a control group and an ob- servation group according to the drawing method ,48 cases each. The control group was treated with escitalo- pram 10-20 mg,oral,one time after breakfast;the observation group was addedolanzapine 5.0-7.5mg,oral, one time after dinner, 12 weeks totally. The Hamilton depression scale（HAMD） and Hamilton sleep disorder factor score of all patients before and after treatment were observed and compared. Results The total effec- tive rate of the observation group was significantly higher than the control group [ 81.25% （ 39/48 ） vs 52.08 % （25/48） ] （P 〈 0.05 ）. After 2,4,8,12 weeks of treatment HA MD scores were decreasing from be- fore treatment, and the observation group decreased faster, the differences between the two groups, between different time points and interaction groups·different time points were statistically significant （ P 〈 0. 05 ）. Subjective sleep quality improvement after 2,4,8,12 weeks of treatment were increasing from before treatment, and the observation group increased faster, the differences between the two groups, between different time points and interaction groups different time points were statistically significant （ P 〈 0.05 ）. The body mass increase rate in the observation group was significantly higher than the control group （ P 〈 0. 05 ）. Conclusion The escitalopram combined olanzapine treatment for refractory depression patients can quickly and effectively relieve symptoms of depression and improve sleep quality, thus is worthy of promotion in clinical.