草酸艾司西酞普兰治疗乳腺癌伴抑郁症患者的效果

Efficacy of Escitalopram Oxalate in Patients with Breast Cancer and Depression

目的探讨草酸艾司西酞普兰对乳腺癌伴抑郁症患者生活质量的影响。方法选取2015年6月至2016年10月我院诊治的66例乳腺癌术后伴抑郁症女性患者,均予环磷酰胺+甲氨蝶呤+氟尿嘧啶方案化疗,并进行心理疏导。草酸艾司西酞普兰片起始剂量为5 mg/d,根据病情调整为10～20 mg/d,治疗8周。应用汉密尔顿抑郁量表(HAMD)评估抑郁症状,应用健康调查简表(SF-36)评估生活质量情况,应用不良反应症状量表(TESS)评估用药安全性,观察并记录临床疗效。结果与治疗前比较,治疗4周后躯体化/焦虑、体质量减轻、认知功能障碍、日夜变化、迟缓、睡眠、绝望等HAMD因子评分明显降低(P <0.05),SF-36量表生理机能、生理职能、躯体疾病、一般健康情况、精力、社会功能、情感职能、精神健康等评分均明显升高(P <0.05)。治疗8周后躯体化/焦虑、体质量减轻、认知功能障碍、日夜变化、迟缓、睡眠、绝望等HAMD因子评分明显降低(P <0.01),SF-36量表生理机能、生理职能、躯体疾病、一般健康情况、精力、社会功能、情感职能、精神健康等评分均明显升高(P <0.01)。临床有效率为81.82%(54/66),且给药期间未见严重不良反应。结论草酸艾司西酞普兰可有效减轻乳腺癌术后患者抑郁症状,提高患者生活质量,安全性较好。

Objective To investigate the effect of escitalopram oxalate on quality of life of patients with breast cancer and depression.Methods Sixty-six patients diagnosed with depression after treatment for breast cancer and who had received cyclophosphamide plus methotrexate plus fluorouracil chemotherapy with psychological counseling were selected.The initial dose of escitalopram oxalate tablets,5 mg/day,subsequently was adjusted to 10 to 20 mg/day,if required.The patients were treated for 8 weeks.The Hamilton Depression Scale(HAMD)was used to assess depressive symptoms,a health survey form(SF-36)was used to assess the quality of life,and an adverse drug reaction symptom scale(TESS)was used to evaluate the safety of the medication.Results The scores for somatization,anxiety,weight loss,cognitive dysfunction,diurnal variation,slow,sleep,despair,and other HAMD categories were lower after 4 weeks(P<0.05)and 8 weeks(P<0.01)of treatment than before treatment,and the scores for physiological function,physiological function,physical disease,general health,energy,social function,emotional function,and mental health on the SF-36 scale were higher after 4 weeks(P<0.05)and 8 weeks(P<0.01)of treatment than before treatment.The clinical efficacy rate was 81.82%(54/66).There were no serious adverse reactions.Conclusion Escitalopram oxalate could effectively and safely reduce the symptoms of depression and improve the quality of life of patients with breast cancer.