坦度螺酮联合文拉法辛对焦虑抑郁共病患者神经递质及相关因子的影响

Effects of tandospirone combined with venlafaxine on neurotransmitters and related factors in patients with comorbid anxiety and depression

目的:观察坦度螺酮联合文拉法辛对焦虑、抑郁共病的治疗效果以及对患者神经递质及相关因子的影响。方法:选取2019年6月至2020年6月于丽水市第二人民医院就诊的焦虑、抑郁共病患者92例,采用随机数字表法分为观察组46例和对照组46例。对照组应用文拉法辛治疗,观察组应用坦度螺酮联合文拉法辛治疗。对比两组治疗前后汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、5-羟色胺、脑源性神经营养因子(BDNF)、神经生长因子(NGF)和药物不良反应发生情况。结果:观察组治疗后4周、8周时HAMA评分[(11.39±3.11)分、(8.26±2.18)分]均低于对照组[(14.72±3.57)分、(10.46±2.37)分](t=4.77、4.63,均P<0.05);观察组治疗后4周、8周时HAMD评分[(15.95±2.90)分、(9.33±1.54)分]均低于对照组[(17.43±2.87)分、(13.28±2.65)分](t=2.46、8.74,均P<0.05);观察组治疗后5-HT、NGF、BDNF水平[(154.59±45.26)μg/L、(13.62±1.16)ng/L、(28.54±2.33)ng/L]均高于对照组[(129.99±48.31)μg/L、(11.98±1.04)ng/L、(25.69±2.51)ng/L](t=2.52、7.14、5.64,均P<0.05);两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.81,P=0.369)。结论:坦度螺酮辅助治疗焦虑、抑郁共病能够显著改善患者焦虑、抑郁情绪,保护神经功能,且药物安全性好。

Objective To investigate the efficacy of tandospirone combined with venlafaxine in the treatment of comorbid anxiety and depression and its effects on neurotransmitters and related factors.Methods A total of 92 patients with comorbid anxiety and depression who received treatment in the Second People's Hospital of Lishui between June 2019 and June 2020 were included in this study.They were randomly divided into an observation group and a control group(n=46/group).The control group was treated with venlafaxine,while the observation group was treated with tandospirone and venlafaxine.Before and after treatment,the scores of Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD),the levels of 5-hydroxytryptamine,brain-derived neurotrophic factor,nerve growth factor,and adverse drug reactions were compared between the two groups.Results At 4 and 8 weeks after treatment,HAMA scores in the observation group were(11.39±3.11)points and(8.26±2.18)points,respectively,which were significantly lower than(14.72±3.57)points and(10.46±2.37)points in the control group(t=4.77,4.63,both P<0.05).At 4 and 8 weeks after treatment,HAMD scores in the observation group were(15.95±2.90)points and(9.33±1.54)points,respectively,which were significantly lower than(17.43±2.87)points and(13.28±2.65)points in the control group(t=2.46,8.74,both P<0.05).After treatment,5-hydroxytryptamine,nerve growth factor,and brain-derived neurotrophic factor levels in the observation group were(154.59±45.26)μg/L,(13.62±1.16)ng/L,(28.54±2.33)ng/L,respectively,which were significantly higher than(129.99±48.31)μg/L,(11.98±1.04)ng/L,and(25.69±2.51)ng/L in the control group(t=2.52,7.14,5.64,all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.81,P=0.369).Conclusion The adjuvant treatment with tandospirone can markedly improve anxiety and depression and protect neurological function of patients with comorbid anxiety and depression,and is highly safe.