阿戈美拉汀治疗首发抑郁症伴失眠的疗效研究

Study on the Effect of Agomelatine in the Treatment of Patients with First-episode Depression Complicated with Insomnia

目的:探讨阿戈美拉汀治疗首发抑郁症伴失眠患者的疗效和安全性。方法:选择2019年1月至2020年2月青岛市精神卫生中心收治的首发抑郁症伴失眠患者40例作为研究对象,随机分为观察组和对照组,每组20例。观察组采用阿戈美拉汀治疗,对照组采用曲唑酮治疗。比较2组的有效率、治疗前及治疗后第4周、第8周的抑郁状态[汉密尔顿抑郁量表(HAMD)]评分、睡眠质量[匹兹堡睡眠质量指数(PSQI)]评分、REM睡眠结构及不良反应[不良反应量表(TESS)]评分。结果:2组患者治疗有效率比较,差异无统计学意义(P>0.05),治疗前2组的HAMD评分及PSQI评分比较,差异均无统计学意义(均P>0.05),治疗后第4周、第8周,观察组的HAMD评分显著低于对照组,治疗后第8周观察组的日间功能、睡眠时间评分显著优于对照组,REM睡眠密度显著低于对照组,REM期持续时间及周期显著长于对照组,TESS量表总分显著低于对照组,差异均有统计学意义(均P<0.05)。结论:阿戈美拉汀可显著改善首发抑郁症伴失眠患者的抑郁及睡眠结构,疗效优于曲唑酮,值得临床推广应用。

Objective:To investigate the efficacy and safety of agomelatine in the treatment of patients with first-episode depression with insomnia.Methods:A total of 40 patients in Qingdao Mental Health Center from January 2019 to February 2020 were randomly divided into observation group(agomelatine group)and control group(trazodone group)with 20 cases in each group.Then the effective rates,depression state[Hamilton Depression Scale(HAMD)],sleep quality[Pittsburgh Sleep quality index(PSQI)]beore the treatment and at 4th and 8th week after the treatment,REM sleep structure and side reaction[Treatment Emergent Symptom Scale(TESS)]of two groups were compared.Results:The effective rates of two groups were compared,there was no statistically significant difference(P>0.05),the HAMD score and PSQI score of two groups before the treatment were compared,there were no statistically significant differences(P>0.05),the HAMD score of observation group at 4th and 8th week after the treatment were significantly lower than those of control group,the daytime function and sleep time at 8th week after the treatment were significantly better than those of control group,REM sleep density was significantly lower than that of control group,REM duration and cycle were significantly longer than those of control group,the total score of TESS was significantly lower than that of control group,there were statistically significant differences(P<0.05).Conclusion:The agomelatine can significantly improve the depression and sleep structure of first-episode depression patients with insomnia,and the curative effect is better than trazodone.