氟哌噻吨美利曲辛联合草酸艾司西酞普兰治疗血液透析患者焦虑、抑郁的效果

Effect of Flupentixol and Melitracen combined with Escitalopram on anxiety and depression in hemodialysis patients

目的评价氟哌噻吨美利曲辛(黛力新)联合草酸艾司西酞普兰对血液透析患者不良心理状态的改善效果。方法抽选保定市第一中心医院自2014年5月至2015年5月收治的行血液透析治疗伴有焦虑、抑郁症患者80例作为研究对象,按照奇偶数法分成观察组和对照组。对照组40例仅使用草酸艾司西酞普兰治疗,观察组40例在对照组基础上加用黛力新治疗,均连续给药3个月。使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)分别在治疗前后各时段评估患者的心理状态;采用匹兹堡睡眠质量指数量表(PSQI)评估治疗前后两组患者睡眠质量改善情况;使用SF-36量表对治疗前后患者的生活质量进行测评;记录两组患者治疗效果、不良反应发生情况。结果治疗前两组患者的HAMD、HAMA评分差异无统计学意义(P均>0.05);治疗4周时两组患者的评分均较治疗前明显下降(P均<0.01);治疗8、12周,两组HAMD评分和HAMA评分比较差异均有统计学意义(P均<0.01)。治疗前两组患者的PSQI、SF-36评分无统计学差异(P均>0.05),治疗12周后观察组各评分优于对照组(P均<0.05);观察组治疗总有效率高于对照组(87.5%vs 67.5%,P<0.05);观察组和对照组不良反应总发生率比较差异无统计学意义(12.5%vs 10.0%,P>0.05)。结论血液透析伴焦虑抑郁症患者联合使用黛力新和草酸艾司西酞普兰治疗,能够迅速改善患者的不良心理状态,安全性满足要求。

Objective To evaluate the effect of Flupentixol and Melitracen（ Deanxit） combined with Escitalopram on the adverse psychological state in hemodialysis patients. Methods Eighty hemodialysis patients with anxiety and depression treated in Baoding First Central Hospital from May 2014 to May 2015 were selected as research objects and were divided into two groups according to the odd and even number method（ n = 40,each）. Escitalopram alone was given in control group,and Deanxit was added based on escitalopram in observation group. All patients were continuously administered for 3 months. Using Hamilton Depression Scale（ HAMD） and Hamilton Anxiety Scale（ HAMA）,the psychological status of patients were evaluated in each period before and after treatment respectively; Pittsburgh sleep quality index scale（ PSQI）was used to evaluate the improvement of sleep quality; SF-36 scale was used to assess the quality of life; efficiency,incidence and types of adverse events in treatment were recorded in two groups. Results There were no significant difference in HAMD and HAMA score between two groups before treatment（ all P〈0. 05）. After 4 weeks of treatment,HAMD and HAMA scores significantly decreased in both two groups（ all P〉0. 01）. After 8 weeks of treatment,HAMD score and HAMA score were respectively in observation group and control group（ all P〈0. 01）. There were also significant differences between two groups after 12 weeks of treatment（ all P〈0. 01）. There were no significant differences in PSQI and SF-36 scores before treatment between two groups（ all P〉0. 05）. After 12 weeks of treatment,the scores in observation group were obviously superior to those in control group（ all P〈0. 05）. The total effective rate was 87. 5% in observation group and 67. 5% in control group（ P〈0. 05）,and there was no statistical difference in the incidence rate of adverse reaction（ 12. 5% vs 10. 0%,P〉0. 05）. Conclusion Escitalopram combined with Deanxit can rapidly improve the adverse psychological state of hemodialysis patients with anxiety and depression safely.