度洛西汀及舍曲林治疗伴躯体症状老年性抑郁症患者疗效及安全性比较

Comparison of curative effect and safety of duloxetine and sertraline in the treatment for patients with senile depression with somatic symptoms

目的 探讨度洛西汀及舍曲林治疗伴躯体症状老年性抑郁症患者疗效及安全性.方法 以2016年6月~2018年6月在我院治疗的120例伴有躯体症状的老年抑郁症患者为研究对象,将其分为对照组和观察组,每组60例.对照组采用舍曲林治疗,观察组采用度洛西汀治疗,两组均治疗6周.分别于治疗前、治疗3周后、治疗6周后采用汉密尔顿抑郁量表工具(Hamilton depression scale,HAMD)对两组患者的抑郁情况进行评估,并根据HAMD评分减分率评价两组患者的临床疗效.治疗过程中,密切关注患者的不良反应,并采用副反应评分(TESS)对两组患者治疗1周后、3周后及6周后的副反应情况进行评估.结果 治疗3周和6周后两组患者的各项抑郁症状因子评分均降低(P<0.05),且治疗6周后均低于治疗3周后(P<0.05),治疗3周和6周后观察组的评分均低于对照组(P<0.05).观察组患者的不良反应率均低于对照组(P<0.05),且在治疗1周、3周、6周后两组的TESS评分均下降,且观察组均低于对照组(P<0.05).两组总有效率比较差异无统计学意义(P>0.05).结论 度洛西汀和舍曲林对伴有躯体症状的老年抑郁症患者均具有良好的临床疗效,可显著降低各项抑郁症状,但度洛西汀的不良反应更少,具有更好的安全性.

Objective To explore curative effect and safety of duloxetine and sertraline in the treatment for patients with senile depression with somatic symptoms.Methods A total of 120 patients with senile depression with somatic symptoms who were treated in our hospital from June 2016 to June 2018 were selected as the study subjects,and divided into the control group and the observation group.The control group was treated with sertraline and the observation group with duloxetine.Both groups were treated for 6 weeks.The Hamilton Depression Scale(HAMD)was used to evaluate the depression of patients before,3 weeks after and 6 weeks after treatment respectively,and the clinical efficacy of patients in the two groups was evaluated according to the HAMD score reduction rates.During treatment,the side effects of patients were paid close attention to,and the side effect scores(TESS)were used to evaluate the side effects of the patients after 1 week,3 weeks and 6 weeks of treatment.Results After 3 weeks and 6 weeks of treatment,scores of various depressive symptom factors in both groups were decreased(P<0.05),and scores after 6 weeks of treatment were lower than those after 3 weeks of treatment(P<0.05).After 3 weeks and 6 weeks of treatment,the scores of the observation group were lower than those of the control group(P<0.05).The rates of adverse reactions in the observation group were lower than those in the control group(P<0.05).TESS scores in both groups were decreased after 1 week,3 weeks and 6 weeks of treatment,and the scores in the observation group were lower than those in the control group(P<0.05).No significant difference in the total effective rates of treatment between the observation group and the control group(P>0.05).Conclusion Duloxetine and sertraline have good clinical efficacy in patients with senile depression with somatic symptoms and can significantly reduce all depressive symptoms,but duloxetine has fewer adverse reactions and better safety.