艾司西酞普兰单用与联合度洛西汀治疗精神分裂症后抑郁的疗效及安全性的对照研究

Efficacy and safety of escitalopram versus escitalopram plus dutoxetine in treatment of patients with post-schizophrenia depression: a case-control study

目的探讨艾司西酞普兰单用与联合度洛西汀治疗精神分裂症后抑郁的疗效及安全性。方法选取精神分裂症后抑郁患者120例,随机分为度洛西汀组、艾司西酞普兰组和联合用药组,每组40例。比较3组治疗前后HAMD-17评分、SF-36评分、临床总有效率及不良反应发生情况。结果治疗3、6周后,3组患者HAMD-17评分均较治疗前显著降低(P<0.05),且联合用药组HAMD-17评分显著低于度洛西汀组、艾司西酞普兰组(P<0.05)。治疗6周后,3组患者SF-36评分均较治疗前显著升高(P<0.05),且联合用药组SF-36评分显著高于度洛西汀组、艾司西酞普兰组(P<0.05)。度洛西汀组总有效率为72.5%,艾司西酞普兰组为75.0%,联合用药组为87.5%。联合用药组总有效率显著高于其他2组(P<0.05)。度洛西汀组不良反应发生率为30.0%,艾司西酞普兰组不良反应发生率为27.5%,联合用药组不良反应发生率为32.5%。结论度洛西汀联合艾司西酞普兰可显著改善精神分裂症患者的抑郁症状,提高治疗有效率,改善患者的生活质量。

Objective To explore the efficacy and safety of escitalopram versus escitalopram plus dutoxetine in treatment of patients with post-schizophrenia depression. Methpatients with post-schizophrenia depression were randomly divided into dutoxetine group , escitalopram group and combination group , 40 cases in each group. The HAMD-17 score , SF-36 score , fective rate and adverse reactions before and after treatment were compared sults Three and six weeks after treatment , the HAMD-17 score dcreased significantly in threegroups （P 〈0. 05） , and the HAMD-17 score of combination group was significantly lower than that of dutoxetine group and escitalopram group （ P 〈 0. 05 ） . Six weeks after treatment , the SF-36 score in-creased significantly in three groups （ P 〈 0. 05 ） , and the SF-36 score of combination group was sig-nificantly higher than that of dutoxetine group and escitalopram group （ P 〈 0. 05 ） . The total effective rate in combination group was 87. 5% , which was significantly higher than 72. 5 % in dutoxetine group and 75. 0% in escitalopram group （P 〈0. 05）. Incidence rates of adverse reactions were30% , 27.5% and 32.5% in duloxetine group , escitalopram group and combination group respective-ly. Conclusion Duloxetine combined with escitalopram can significantly improve symptoms of de-pression in patients with schizophrenia , increase the therapeutic efficiency , and life of patients.