抗抑郁药及性激素治疗围绝经期及绝经后妇女抑郁症的疗效比较

Comparison of efficacy of antidepressants and sex hormones in the treatment of depression in perimenopausal and postmenopausal women

目的对比抗抑郁药以及性激素治疗围绝经期及绝经后妇女抑郁症的疗效。方法129例围绝经期及绝经后妇女抑郁症患者为研究对象,根据治疗方法的不同分为对照组(65例)及观察组(64例)。对照组予以抗抑郁药盐酸氟西汀治疗,观察组予以性激素替勃龙治疗。比较两组患者的临床疗效,用药不良反应发生率,治疗前后的汉密尔顿抑郁量表(HAMD)评分。结果观察组患者的治疗总有效率为95.31%,与对照组的92.31%比较,差异无统计学意义(P>0.05)。观察组患者的用药不良反应发生率为9.38%,与对照组的10.77%比较,差异无统计学意义(P>0.05)。观察组患者治疗前的HAMD评分为(15.65±3.06)分、治疗后为(3.36±0.66)分,对照组患者治疗前的HAMD评分为(16.11±3.07)分、治疗后为(3.50±0.67)分。治疗前,两组患者的HAMD评分比较,差异无统计学意义(P>0.05);治疗后,两组患者的HAMD评分均低于本组治疗前,差异具有统计学意义(P<0.05);但两组治疗后的HAMD评分比较,差异无统计学意义(P>0.05)。结论围绝经期及绝经后妇女抑郁症患者通过抗抑郁药和性激素进行治疗在疗效上没有明显的差异,安全性也相当,都能发挥改善抑郁症状的目的,所以可以根据医疗机构的实际情况或患者的需求,合理的选择。

Objective To compare the efficacy of antidepressants and sex hormones in the treatment of depression in perimenopausal and postmenopausal women.Methods A total of 129 perimenopausal and postmenopausal women with depression were divided into control group(65 cases)and observation group(64 cases)according to different treatment methods.The control group was treated with the antidepressantfluoxetine hydrochloride,and the observation group was treated with the sex hormone-tibolone.The clinical efficacy,incidence of adverse drug reactions and Hamilton Depression Rating Scale(HAMD)score before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 95.31%,while that of the control group was 92.31%,and the difference was not statistically significant(P>0.05).The incidence of adverse drug reactions in the observation group was 9.38%,while that in the control group was 10.77%,and the difference was not statistically significant(P>0.05).HAMD score of the observation group was(15.65±3.06)points before treatment and(3.36±0.66)points after treatment;HAMD scores of the control group was(16.11±3.07)points before treatment and(3.50±0.67)points after treatment.Before treatment,there was no statistically significant difference in HAMD scores between the two groups(P>0.05).After treatment,HAMD scores in both groups were lower than those before treatment in this group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in HAMD scores between the two groups after treatment(P>0.05).Conclusion There is no significant difference in efficacy between antidepressants and sex hormones in the treatment of perimenopausal and postmenopausal women with depression,and the safety is comparable,both of them can play a role in improving the symptoms of depression,so they can be rationally selected according to the actual situation of the medical institutions or the patient's needs.