氟西汀联合奥氮平治疗伴自杀意念抑郁症的效果

Clinical efficacy of fluoxetine combined with olanzapine for depression complicated with suicidal ideation

目的观察氟西汀联合奥氮平治疗伴自杀意念抑郁症的效果,为该疾病的治疗提供参考。方法选取2014年1月-2016年1月新疆维吾尔自治区人民医院收治的70例伴自杀意念抑郁症患者,均符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)抑郁症诊断标准。采用随机数字表法分为研究组和对照组各35例。对照组采用氟西汀治疗,研究组采用氟西汀联合奥氮平治疗,两组均治疗8周。于治疗前后进行汉密尔顿抑郁量表17项版(HAMD-17)和自杀意念自评量表(SIOSS)评定,采用自编不良反应记录表记录两组不良反应发生情况。结果对照组和研究组在不同时间点HAMD-17评分比较差异均有统计学意义(对照组F=204.3,P<0.01,研究组F=292.6,P<0.01),SIOSS评分在不同时间点比较差异均有统计学意义(对照组F=15.6,P<0.01,研究组F=21.8,P<0.01)。治疗第2、4、8周末,研究组HAMD-17评分均低于对照组(P均<0.01),有自杀意念者的比例和SIOSS评分均低于对照组(P<0.05或0.01)。两组不良反应发生率比较差异无统计学意义(χ~2=0.971,P=0.325)。结论与单用氟西汀比较,氟西汀联合奥氮平治疗可能更有助于改善伴自杀意念抑郁症患者抑郁症状和自杀意念。

Objective To investigate the clinical efficacy of fluoxetine combined with olanzapine for depression patients complicated with suicidal ideation, and to provide refrence for the treatment of the disease. Methods From January 2014 to January 2016, 70 depression patients complicated with suicidal ideation in the People s Hospital of Xinjiang Uygur Autonomous Region were randomly divided into two groups, the study group （n=35） and the control group （n = 35） according to the random number table. All were met the diagnostic of Diagnostic and Statistical Manual of Mental Disorders, fourth edition（ DSM - IV）. The control group was treated with fluoxetine, and the study group was treated with fluoxetine combined with olanzapine. Both groups were treated for 8 weeks. Hamilton Depression Scale - 17 item（ HAMD - 17） and Self - rating Idea of Suicide Scale （ SIOSS） were used to assess them, and the adverse reactions were recorded by self - made adverse events record sheet. Results At different time points, the HAMD - 17 scores showed significant differences in both two groups （the control group F = 204. 3 , P 〈 0. 01, the study group F = 292. 6 , P 〈 0. 0 1 ） , the SIOSS scores had significant differences in both two groups （the control group F = 15. 6 , P 〈 0. 01 , the study group F = 21. 8, P 〈0. 01） . At the 2nd, 4th and 8th week after treatment, the HAMD - 17 scores of the study group were lower than those of the control group （ P 〈 0. 01） , and the proportion of suicidal ideation and SIOSS scores were also lower than those of the control group （P 〈0. 05 or 0. 01） . There was no significant difference in the incidence of adverse reactions between the two groups（χ2=0. 971, P = 0. 325）. Conclusion Compared with fluoxetine alone, fluoxetine combined with olanzapine therapy may be more helpful in improving depressive symptoms and suicidal ideation in depression patients with suicidal ideation.