不同药物治疗方案对难治性抑郁症患者社会功能的影响

Analysis of the influence of different drug therapy on the social function of patients with refractory depression

目的探讨不同药物治疗方案对难治性抑郁症患者社会功能的具体影响。方法选择2015年10月至2017年10月本院收治的300例难治性抑郁症患者,随机分为A、B、C、D、E、F共6组,每组50例,分别采用帕罗西汀、文拉法辛、米氮平、帕罗西汀联合利培酮、帕罗西汀联合丙戊酸钠、帕罗西汀联合丁螺环酮治疗。分别于基线时和双盲治疗2个月后,采用社会功能缺陷筛选量表(social disability screening schedule,SDSS)、17项汉斯顿抑郁量表(Hanston depression rating scale-17,HAMD-17)、健康调查问卷(survey questionnaire-36,SF-36)对各组患者进行测评,观察治疗效果。结果治疗2个月后,各组SDSS评分均较基线时明显下降(P<0.05),且6组间SDSS评分差异有显著性(P<0.05)。各组治疗后SF-36社会功能因子评分与基线时比较均明显提高,差异有显著性(P<0.05)。治疗2个月后SDSS评分变化值与本次病期、HAMD-17基线评分呈正相关(r=0.028,P=0.023;r=0.212,P=0.000),与HAMD-17评分变化值呈负相关(r=-0.281,P=0.000)。结论不同的药物治疗方案对难治性抑郁症患者的社会功能均有一定改善作用,但改善程度及时序有所不同。影响患者社会功能改善的主要因素包括药物的疗效、患者本身的抑郁程度以及本次病期等。

Objective To analyze the specific effects of different medication regimens on the social function of patients with refractory depression. Method Three hundred cases in our hospital from October 2015 to October 2017 were refractory depression patients were divided into A, B, C, D, E, F a total of 6 experimental group, 50 cases in each group, A group using the Palo Shiden treatment, B group using the Vin Rafa Sin treatment, C group use of mirtazapine in the treatment of group D, B cefoxitin combined with risperidone in the treatment of group E, the use of Paroxetine Combined with sodium valproate treatment, F group use of Paroxetine Combined with buspirone in the treatment group, 6 double-blind treatment for 2 months, respectively at baseline and after February, social disability screening schedule（SDSS）, 17 item Hanston Depression Rating Scale（HAMD-17） and the health survey questionnaire（SF-36） for patients with evaluation, curative effect. Result After February, there were significant differences between the 6 groups of SDSS score（P〈0.05）, 6 groups of treatment SF-36 and social function scores after 2 weeks of treatment compared to before, there were significant differences（P〈0.05）, SDSS scores were compared between the 6 groups, there was significant difference（P〈0.05）, multiple linear regression analysis showed that by baseline HAMD-17 score and after February, the decline in the stage of the disease affects the change of SDSS score after treatment in February. Conclusion Six kinds of drug treatment, can improve the social function of patients with refractory depression, but the degree of improvement and improve the timing difference in the study found that the drug efficacy, main factors affecting the social function of the patients with depression of patients with the disease itself and period.