艾司西酞普兰联合奥氮平治疗难治性抑郁症的效果探讨

Effect of escitalopram combined with olanzapine in the treatment of refractory depression

目的探讨艾司西酞普兰联合奥氮平治疗难治性抑郁症的临床疗效。方法102例难治性抑郁症患者,随机分为观察组和对照组,各51例。对照组采用艾司西酞普兰治疗,观察组在对照组基础上采用奥氮平治疗。比较两组患者治疗效果及治疗前后的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分。结果观察组患者治疗总有效率为88.24%,明显高于对照组的68.63%,差异有统计学意义(P<0.05)。治疗前及治疗后15、30、45、60 d,对照组患者HAMD评分分别为(31.57±4.89)、(21.85±4.22)、(17.48±4.53)、(15.45±4.37)、(13.51±3.87)分,观察组患者分别为(31.45±4.63)、(16.36±4.03)、(12.38±3.74)、(9.73±3.66)、(7.48±2.62)分。治疗前,两组患者HAMD评分比较差异无统计学意义(P>0.05);治疗后15、30、45、60 d,两组患者HAMD评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗前及治疗后15、30、45、60 d,对照组患者HAMA评分分别为(21.52±4.76)、(16.81±4.05)、(13.03±4.33)、(12.43±4.52)、(11.63±3.20)分,观察组患者分别为(21.27±4.84)、(12.27±3.86)、(10.46±3.68)、(8.73±3.58)、(5.64±2.71)分。治疗前,两组患者HAMA评分比较差异无统计学意义(P>0.05);治疗后15、30、45、60 d,两组患者HAMA评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论使用艾司西酞普兰联合奥氮平治疗难治性抑郁症效果显著,可有效改善患者焦虑、抑郁情绪,值得进一步推广应用。

Objective To discuss the clinical efficacy of escitalopram combined with olanzapine in the treatment of refractory depression.Methods A total of 102 patients with refractory depression were randomly divided into observation group and control group,with 51 cases in each group.The control group was treated with escitalopram,and the observation group was treated with olanzapine on the basis of control group.The therapeutic effects and scores of Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)before and after treatment were compared between the two groups.Results The total effective rate in the observation group was 88.24%,which was significantly higher than that of 68.63%in the control group,and the difference was statistically significant(P<0.05).Before treatment and 15,30,45 and 60 d after treatment,the HAMD scores of the control group were(31.57±4.89),(21.85±4.22),(17.48±4.53),(15.45±4.37)and(13.51±3.87)points,and those of the observation group were(31.45±4.63),(16.36±4.03),(12.38±3.74),(9.73±3.66)and(7.48±2.62)points.Before treatment,there was no statistically significant difference in HAMD scores between the two groups(P>0.05).At 15,30,45 and 60 d after treatment,the HAMD scores in the two groups were lower than those before treatment in this group,and the observation group was lower than the control group.The difference was statistically significant(P<0.05).Before treatment and 15,30,45 and 60 d after treatment,the HAMA scores of the control group were(21.52±4.76),(16.81±4.05),(13.03±4.33),(12.43±4.52)and(11.63±3.20)points,and those of the observation group were(21.27±4.84),(12.27±3.86),(10.46±3.68),(8.73±3.58)and(5.64±2.71)points.Before treatment,there was no statistically significant difference in HAMA scores between the two groups(P>0.05).At 15,30,45 and 60 d after treatment,the HAMA scores in both groups were lower than those before treatment in this group,and the observation group was lower than the control group.The difference was statistically significant(P<0.05).Conclusion The combination of escitalopram and olanzapine is significantly effective in the treatment of refractory depression,which can effectively improve the anxiety and depression of patients,and is worthy of further promotion and application.