艾司西酞普兰与帕罗西汀治疗女性抑郁症对照研究

A control study of escitalopram and paroxetine in the treatment of female patients with depressive disorder

目的比较艾司西酞普兰与帕罗西汀治疗女性抑郁症的疗效及安全性。方法选择2015年6月至2016年6月厦门市海军医院收治的46例女性抑郁症患者随机分为艾司西酞普兰组和帕罗西汀组,每组23例。艾司西酞普兰组患者给予艾司西酞普兰,初始剂量每日10 mg,晨服,根据患者病情2周内加至每日15~20 mg;帕罗西汀组患者给予帕罗西汀治疗,初始剂量为每日20 mg,分2次口服,根据患者病情2周内加至每日40~60 mg;疗程6周。应用汉密尔顿抑郁量表(HAMD)和不良反应量表评定疗效及不良反应。结果治疗1、2、4、6周后,2组患者HAMD评分均低于治疗前(P<0.05)。治疗前及治疗1周后2组患者HAMD评分比较差异无统计学意义(P>0.05);治疗2、4周后艾司西酞普兰组患者HAMD评分低于帕罗西汀组(P<0.05);治疗6周后2组患者HAMD评分比较差异无统计学意义(P>0.05)。艾司西酞普兰组和帕罗西汀组患者治疗有效率分别为95.7%(22/23)、91.3%(21/23),2组患者治疗有效率比较差异无统计学意义(P>0.05)。艾司西酞普兰组和帕罗西汀组患者不良反应发生率为30.4%(7/23)、65.2%(15/23),艾司西酞普兰组患者不良反应发生率低于帕罗西汀组(P<0.01)。结论艾司西酞普兰与帕罗西汀治疗女性抑郁症患者疗效相当,但在改善症状方面优于帕罗西汀,且不良反应发生率低。

Objective To compare the clinical effect and safety of escitalopram and paroxetine in the treatment of female patients with depressive disorder. Methods Forty-six female patients with depressive disorder were selected from June2015 to June 2016 in Naval Hospital of Xiamen City. The patients were randomly divided into escitalopram group and paroxetine group. The patients in escitalopram group were given escitalopram 10 mg per day as initial dose,according to the disease state the dose was added to 15-20 mg in two weeks. While the patients in paroxetine group were given paroxetine 20 mg per day as initial dose,then according to the disease state the dose was added to 40-60 mg in two weeks. The course of treatment was six weeks. The efficacy was evaluated with Hamilton depression rating scale（ HAMD） and adverse reactions was evaluated with the treatment emergent symptom scale. Results The score of HAMD in the two groups at one,two,four and six weeks after treatment was lower than that before treatment（ P〈0. 05）. There was no significant difference in the score of HAMD between before treatment and at one week after treatment in the two groups（ P〉0. 05）. The score of HAMD in escitalopram group was lower than that in paroxetine group at two and four weeks after treatment P〈0. 05）,but there was no significant difference in the score of HAMD between escitalopram group and paroxetine group at six weeks after treatment（ P〉0. 05）. The effective rate of treatment in escitalopram group and paroxetine group was 95. 7% and 91. 3%,respectively. There was no significant difference in the effective rate of treatment between the two groups（ P〈0. 05）. The incidence of untoward effect in escitalopram group and paroxetine group was 30. 4% and 65. 2%. The incidence of untoward effect in escitalopram group was lower than that in paroxetine group（ P〈0. 01）. Conclusion The effect of escitalopram and paroxetine in treating female patients with depressive disorder is equivalent. Escitalopram has better role in improving symptom of depressive disorder and lower incidence rate of untoward effect.