帕罗西汀联合奥氮平对抑郁症并发睡眠障碍患者的疗效及安全性

Efficacy and safety of paroxetine combined with tacrolimus in the treatment of patients in depression associated with sleep disorder

目的:观察帕罗西汀联合奥氮平对抑郁症并发睡眠障碍患者的疗效及安全性。方法:选取2016年3—7月本院收治的80例抑郁症并发睡眠障碍患者作为研究对象,随机分为观察组和对照组各40例。对照组患者仅选用盐酸帕罗西汀片口服治疗,初始剂量为20 mg/次,1次/d,随后根据患者具体情况调整用药,最高剂量不超过40 mg/d,总疗程为8周;观察组在对照组的基础上联合奥氮平片(再普乐)治疗,奥氮平片初始剂量为10 mg/次,1次/d,随后根据患者具体情况调整用药,最高剂量不超过20 mg/d,总疗程为8周。比较两组患者治疗前及治疗后第4周和第8周的汉密尔顿抑郁量表(HAMD)评分、睡眠总时间和觉醒时间;比较两组患者出现头晕、恶心、乏力等不良反应的情况。结果:两组患者治疗后第4周和第8周的HAMD评分均较治疗前低(P<0.05),且观察组均低于对照组,差异具有统计学意义(P<0.05);治疗后第4周和第8周,相较治疗前两组患者的睡眠总时间均增加,差异具有统计学意义(P<0.05),两组治疗后同一时间点比较,观察组睡眠状况均优于对照组,差异具有统计学意义(P<0.05);治疗后,观察组患者出现头晕、乏力、恶心、体重增加等不良反应的概率(47.50%)高于对照组(15.00%),差异具有统计学意义(P<0.05)。结论:帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍有较好的疗效,具有积极的临床意义,值得推广,临床应用时应根据患者情况调整剂量,防范不良反应。

Objective : To observe the efficacy and safety of paroxetine combined with olanzapine(olanzapine tablets) in the treatment of depression complicated with sleep disorder. Methods : A total of 80 cases of depressive disorder complicated with sleep disorders in our hospital 3～7 month 2016 were randomly divided into the observation group and the control group, each with 40 cases. Patients in the control group only use Paroxetine Hydrochloride Tablets oral treatment, the initial dose of 20 mg/times, 1 times/d,then adjust medication according to the specific circumstances of patients, the maximum dose of 40 mg/d, the total treatment duration was 8 weeks; the observation group based on olanzapine tablets for olanzapine tablets, the initial dose of 10 mg/times,1 times/d, then adjust medication according to the specific circumstances of patients, the maximum dose of 20 mg/d,the total treatment duration was 8 weeks. Comparison of two groups of patients before and after treatment around eighth weeks of the Hamilton Depression Scale( HAMD) score, total sleep time and awakening time; comparison of two groups of adverse reactions in patients with dizziness, nausea and fatigue. Results : Two groups of patients after around eighth weeks of the HAMD scores were low(P<0.01), and the observation group were lower than the control group, the difference was statistically significant(P<0.05), eighth weeks after treatment, compared with before treatment, two groups of patients with total sleep time increased. The awakening time were reduced, compared with before treatment, the difference was statistically significant(P<0.05), between the two groups after treatment, at the same time point of observation group were better than the control group, the difference was statistically significant(P<0.05); after treatment, the observation group patients with dizziness, fatigue, nausea, weight gain the adverse reaction probability(47. 50%) higher than that of the control group(15%), the difference was statistically significant( P <0.05). Conclusion : Paroxetine combined with olanzapine in the treatment of patients with depression with sleep disorder has good curative effect, has positive clinical significance, is worthy to be popularized in clinical application, the dosage should be adjusted according to the conditions of patients, prevention of adverse reactions.