阿立哌唑联合阿戈美拉汀对抑郁症患者抑郁情绪、睡眠质量及神经递质指标的影响

Effects of aripiprazole combined with agomelatine on depression,sleep quality and neurotransmitters in depression patients

目的探究阿立哌唑联合阿戈美拉汀对抑郁症患者抑郁情绪、睡眠质量及神经递质指标的影响。方法选取济南市嬴城荣军医院抑郁症患者102例作为研究对象,按照随机数字表法分组(n=51)。对照组采用阿戈美拉汀治疗,观察组采用阿立哌唑联合阿戈美拉汀治疗。比较2组治疗效果、治疗前后抑郁情绪[汉密尔顿抑郁量表(HAMD)评分、蒙哥马利抑郁量表(MARDS)评分]、匹兹堡睡眠质量指数(PSQI)、认知功能重复性成套神经心理状态测验(RBANS)评分、神经递质指标[谷氨酸(Glu)、γ-氨基丁酸(GABA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、乙酰胆碱(Ach)、多巴胺(DA)]、神经因子[S100β蛋白(S100β)、脑源性神经营养因子(BDNF)]及不良反应量表(TESS)评分。结果观察组总有效率高于对照组(P<0.05);观察组治疗2、4、6周后HAMD、MARDS评分低于对照组(P<0.05);观察组治疗2、4、6周后Glu低于对照组,NE、Ach、DA、5-HT、GABA高于对照组(P<0.05);观察组治疗2、4、6周后血清S100β低于对照组,BDNF高于对照组(P<0.05)。观察组治疗6周后PSQI评分低于对照组(P<0.05);观察组治疗6周后语言、空间结构、即刻记忆、延迟记忆、注意力评分高于对照组(P<0.05);2组治疗2、4、6周后TESS评分比较差异无统计学意义(P>0.05)。结论阿立哌唑联合阿戈美拉汀治疗抑郁症可增强治疗效果,调节神经递质水平,改善神经功能,提高睡眠质量,减轻抑郁症状。

Objective To explore the effect of aripiprazole combined with agomelatine on depression,sleep quality and neurotransmitters in depression patients.Methods A total of 102 depression patients in Yingcheng Rongjun Hospital were enrolled.According to the random number table method,they were divided into two groups(n=51).The control group was treated with agomelatine,while the observation group was treated with aripiprazole combined with agomelatine.Both groups were compared for therapeutic effect,depression mood[Hamilton Depression Scale(HAMD)score,and Montgomery-Asberg Depression Rating Scale(MARDS)score],Pittsburgh Sleep Quality Index(PSQI),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)score,neurotransmitter index[glutamate(Glu),γ-aminobutyric acid(GABA),serotonin(5-HT),norepinephrine(NE),acetylcholine(Ach),and dopamine(DA)],nerve factor[S100βprotein(S100β),and brain-derived neurotrophic factor(BDNF)]and Treatment Emergent Symptom Scale(TESS)scores before and after treatment.Results The observation group showed a higher total effective rate than the control group(P<0.05).The HAMD and MARDS scores of the observation group were lower than those of the control group after two,four,and six weeks of treatment(P<0.05).After two,four,and six weeks of treatment,the observation group presented decreases in Glu,and increases in NE,Ach,DA,5-HT,and GABA,compared with the control group(P<0.05).The observation group showed lower serum S100βand higher BDNF than the control group after two,four,and six weeks of treatment(P<0.05).The observation group produced a higher PSQI score than the control group after six weeks of treatment(P<0.05).After six weeks of treatment,language,spatial structure,immediate memory,delayed memory,and attention scores increased in the observation group,compared with those in the control group(P<0.05).There was no statistical difference in TESS scores between the two groups after two,four and six weeks of treatment(P>0.05).Conclusions Aripiprazole combined with agomelatine is effective for the treatment of depression,which can enhance therapeutic effects,adjust the level of neurotransmitters,improve neurological function,improve the quality of sleeping,and relieve symptoms of depression.