摘要
目的:观察拉莫三嗪联合MECT治疗难治性抑郁症的疗效;方法:选取符合入组条件的难治性抑郁症门诊或住院患者47名,采取病例组对照的方法,运用拉莫三嗪联合MECT治疗,观察期限6周。入组后拉莫三嗪1周后加至200mg/d;自第2周始,每周3次,隔日治疗,均接受总数8次的MECT治疗。对照组选取住院符合难治性的抑郁症患者39例,采取拉莫三嗪联合假性MECT治疗的方法,药物剂量同观察组。两组的效果评估采取精神科医生精神现况检查评估、患者及家属自我体验效果结合抑郁自评量表(SDS)和17项版本的汉密尔顿抑郁量表减分率共同评价。结果:研究组完成观察数44例。终止观察3例,脱落率6.38%,其中因出现皮疹终止观察2例,自行停止观察1例。对照组完成观察数37例,脱落2例,脱落率5.13%;两组的脱落率和副反应比较差异没有显著性(P>0.05)。研究结果显示,两组分别在精神科现况检查(PSE)、患者/家属体验、SDS和汉密尔顿抑郁量表(17项版本)的评定结果中,"痊愈"项目的两组间比较均显示出了差异性(χ~2=6.11,9.01,10.23,8.24;P<0.01)。患者/家属体验评估中两组间的"有效"指标比较,差异有显著性(χ~2=2.66,P<0.05);余项目的两组间比较没有显示出差异性(P>0.05)。结论:拉莫三嗪联合MECT治疗难治性抑郁症安全有效,可以作为候选方案之一;单用拉莫三嗪治疗难治性抑郁症疗效尚不确定。
Objective:To observation the treatment effect of lamotrigine combined modern electric-convulsive treatment(MECT)in treatment-resistant depression patients.Methods:A total of 47 patients were included in study group who met treatment-resistant refractory depression criteria and were treated by lamotrigine combined with MECT.Observation period was 6 weeks.Lamotrigine dosage was titrated to 200 mg per day after the first week.And we combined MECT from the second week,3 times a week,total 8 times.A total of 39 hospitalized patients were recruited in control group who met treatment-resistant refractory depression criteria too and were treated by lamotrigine combined with pseudo-MECT.The control group patients took the dosage of lamotrigine as same as the study group.Assessment of efficacy were taken three methods:Present state examination(PSE),the effect of selfexperience from patients or their relatives,and using SDS and HAMD-17 item scales for survey and check respectively.Results:Of 47 patients in study group,3 cases discontinued,expulsion rate was 6.38%.Of 39 patients in control group,2 cases discontinued,expulsion rate 5.13%.There was no difference between this two groups(P〉0.05).There were significant difference in PSE,the effect of self-experience from patients or their relatives,and using SDS and HAMD-17 item scales for survey and check respectively(χ~2=6.11,9.01,10.23,8.24;P〈0.01)between items:Comparison of the "recovery" items between two groups,and comparison of the "recovery plus effective" and "ineffective" in study group.There were difference between items(χ~2=2.66,P〈0.05): "Effective" item in two groups for the effect of self-experience from patients or their relatives.There were no difference for compare between item(P〉0.05):Comparison of the "recovery plus effective" and "ineffective" in control group,and "effective" item in two groups.Conclusion:This treatment program of lamotriging combined with MECT is safety and effective in treatment-resistant depression patients as one of the candidate schemes.But the effect of single drug regimen with lamotrigine for these patients is unknown.
出处
《中国健康心理学杂志》
2017年第8期1149-1152,共4页
China Journal of Health Psychology