文拉法辛治疗抑郁症的临床效果及对患者自主神经功能、心率变异性的影响

Effects of Venlafaxine on Depression and Its Effects on Autonomic Nerve Function and Heart Rate Variability

目的探讨文拉法辛治疗抑郁症的临床效果及对患者自主神经功能、心率变异性的影响。方法选取2018年7月至2019年7月于丹东市第三医院接受治疗的108例抑郁症患者作为研究对象,根据治疗方法不同将其分为两组,对照组54例(脱落5例,完成研究49例)与观察组54例(脱落3例,完成研究51例)。对照组给予艾司西酞普兰,观察组采用文拉法辛治疗,比较两组治疗效果、心率变异性指标、自主神经功能指标。结果治疗后,两组患者汉密尔顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分低于治疗前,且观察组HAMA评分低于对照组,差异有统计学意义(P<0.05);治疗后,观察组正常RR间期标准差(SDNN)、5个正常RR间期均值标准差(SDANN)、频域总值(TP)、低频(LF)、高频(HF)水平高于对照组,相差>50 ms时相邻RR间期所占百分比(PNN50)水平低于对照组,差异有统计学意义(P<0.05);治疗后,观察组交感神经皮肤反应(SSR)检测波波幅高于对照组,潜伏期低于对照组,差异有统计学意义(P<0.05)。结论艾司西酞普兰和文拉法辛均能有效缓解抑郁症患者抑郁症状,效果相当,但文拉法辛可有效改善患者焦虑、心率变异性和自主神经功能。

Objective To explore the efficacy of venlafaxine in the treatment of depression and its effects on autonomic nervous function and heart rate variability. Methods A total of 108 patients with depression in the Third Hospital of Dandong City were selected as the research objects and were divided into 2 groups according to different therapeutic methods. The control group had 54 cases(5 cases dropped, 49 completed) and the observation group had 54 cases(3 cases dropped, 51 completed). The control group was given escitalopram and the observation group was given venlafaxine. The treatment effects, heart rate variability index and autonomic nerve function index were compared between the 2 groups. Results After treatment, HAMA score and HAMD score of the 2 groups were lower than those before treatment, and HAMA score of the observation group was lower than that of the control group(P<0.05);after treatment, the levels of SDNN, SDANN in 5 normal period, TP, LF and HF in the observation group were higher than those in the control group. When the difference was greater than 50 ms, the percentage of adjacent RR intervals(PNN50) was lower than that of the control group, the difference is statistically significant(P < 0.05). After treatment, the detection wave amplitude of SSR in the observation group was higher than that in the control group, and the latency was lower than that in the control group, and the difference was statistically significant(P <0.05). Conclusion Escitalopram and venlafaxine can effectively relieve depressive symptoms of patents with depression,with great efficacy, but venlafaxine can improve anxiety, heart rate variability and autonomic nerve function.