MECT联合阿戈美拉汀治疗女性抑郁症伴睡眠障碍的疗效

Effect of MECT combined with agomelatine on female patients with depression and sleep disorder

目的:探讨改良无抽搐电休克疗法(MECT)联合阿戈美拉汀治疗女性抑郁症伴睡眠障碍的疗效。方法:根据治疗方式不同将98例女性抑郁症伴睡眠障碍患者分为治疗组(n=49)和对照组(n=49),对照组予以常规治疗+阿戈美拉汀,治疗组在对照组的基础上予以MECT治疗,两组均治疗8周。比较两组的临床疗效、临床症状评分[汉密尔顿抑郁量表(17项)(HAMD-17)和匹兹堡睡眠指数量表(PSQI)]、生化指标[血清褪黑素(MT)、脑源性神经营养因子(BDNF)、促卵泡激素(FSH)、性激素雌二醇(E_(2))、白介素-1β(IL-1β)、白介素-2(IL-2)、IL-6]及不良反应。结果:治疗组临床有效率高于对照组(95.92%vs.83.67%,P<0.05);治疗组HAMD、PSQI评分及FSH、IL-2、IL-6、IL-1β低于对照组(P<0.05),MT、BDNF及E_(2)高于对照组(P<0.05);治疗组不良反应率与对照组比较,差异无统计学意义(P>0.05)。结论:MECT联合阿戈美拉汀治疗中重度抑郁伴睡眠障碍的疗效较确切,可能与调节血清BDNF、MT及内分泌-神经系统等作用机制相关。

Objective:To investigate the effects of modified electra convulsive therapy(MECT)combined with agomelatine in the treatment of female patients with depression and sleep disorder.Methods:98 female patients with depression and sleep disorders were selected as the research objects,and were randomly divided into treatment group(n=49)and control group(n=49).The control group was given conventional treatment+agomelatine,and the treatment group was given MECT on the basis of the control group.Both groups were treated for 8 weeks.Clinical efficacy,clinical symptom score[Hamilton Depression Scale(17)(HAMD-17)and Pittsburgh Sleep Index scale(PSQI)],biochemical indexes[serum melatonin(MT),brain-derived neurotrophic factor(BDNF),follicle-stimulating hormone(FSH),sex hormone estradiol(E_(2)),interleukin-1β(IL-1β),interleukin-2(IL-2),interleukin-6(IL-6)]and adverse reactions were compared between the two groups.Results:The clinical effective rate of treatment group was significantly higher than that of control group(95.92%vs.83.67%,P<0.05).HAMD,PSQI scores,FSH,IL-2,IL-6 and IL-1βin treatment group were significantly lower than those in control group(P<0.05),MT,BDNF and E_(2)were significantly higher than those in control group(P<0.05).There was no significant difference in the rate of adverse recation between the treatment group and the control group(P>0.05).Conclusion:MECT combined with agomelatine has definite efficacy in the treatment of moderate and severe depression with sleep disorder,which may be related to the mechanism of regulating serum BDNF,MT and endocrine-nervous system.