不同剂量奥氮平治疗老年抑郁障碍伴焦虑痛苦患者的疗效

Efficacy of Different Doses of Olanzapine in Treating Elderly Patients with Depressive Disorders Accompanied by Anxiety and Pain

【目的】探讨不同剂量奥氮平治疗老年抑郁障碍伴焦虑痛苦患者的疗效及对患者躯体症状及睡眠质量的影响。【方法】本院就诊的120例老年抑郁障碍伴焦虑痛苦患者,随机分为观察组与对照组,每组60例。两组均给予帕罗西汀治疗,对照组患者在此基础上给予大剂量奥氮平(10 mg/次),观察组给予小剂量奥氮平(2.5 mg/次)治疗,两组均治疗3个月。比较两组的疗效及不良反应发生情况;比较两组患者治疗前后的汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、躯体症状严重程度量表(PHQ-15)评分、匹兹堡睡眠质量指数(PSQI)评分及空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)水平。【结果】两组治疗总有效率比较,差异无统计学意义(P>0.05)。两组治疗前及治疗后HAMD评分、HAMA评分、PHQ-15评分比较,差异均无统计学意义(P>0.05);两组治疗后HAMD评分、HAMA评分、PHQ-15评分显著低于治疗前(P<0.05)。两组治疗前及治疗后PSQI各项评分及总分比较,差异均无统计学意义(P>0.05),两组治疗后PSQI各项评分及总分显著低于治疗前(P<0.05)。两组治疗前FBG、TC、TG比较,差异无统计学意义(P>0.05);治疗后,对照组FBG、TC、TG显著高于治疗前,且对照组显著高于观察组(P<0.05)。观察组不良反应总发生率显著低于对照组(P<0.05)。【结论】奥氮平可改善老年抑郁障碍伴焦虑痛苦患者抑郁、焦虑、躯体症状和睡眠质量,使用小剂量奥氮平可减少高血糖、高脂血症发生的风险,且不良反应少。

【Objective】To investigate the efficacy of different doses of olanzapine in treating elderly depression patients with comorbid anxiety and pain,as well as its effects on somatic symptoms and sleep quality.【Methods】A total of 120 elderly patients with depression plus comorbid anxiety and pain from our hospital were randomly divided into a low-dose group and a high-dose group,with 60 patients in each group.Both groups were treated with paroxetine,while patients in the control group received a high dose of olanzapine(10 mg/dose)and in the observation group received a low dose of olanzapine(2.5 mg/dose),both for three months.The effectiveness and adverse reactions of the two groups were compared.The scores on the Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Patient Health Questionnaire-15(PHQ-15)for the severity of somatic symptoms,Pittsburgh Sleep Quality Index(PSQI),and levels of fasting blood glucose(FBG),total cholesterol(TC)and triglycerides(TG)were compared before and after treatment in both groups.【Results】There was no significant statistical difference in the overall effectiveness rate between the two groups(P>0.05).There were no significant statistical differences in the HAMD,HAMA,and PHQ-15 scores between the two groups either before or after treatment(P>0.05),while there was a significant reduction in the scores after treatment if compared to before treatment in each group(P<0.05).There were no significant statistical differences in the individual and total PSQI scores between the two groups before and after treatment(P>0.05),however,the scores of both groups after treatment were significantly lower than those before treatment(P<0.05).There were no significant statistical differences in levels of FBG,TC and TG between the two groups before treatment(P>0.05).After treatment,the FBG,TC,and TG levels in the high-dose group were significantly higher than those before treatment,while the FBG,TC and TG levels of the high-dose group were significantly higher than those of the low-dose group(P<0.05).The total incidence of adverse reactions in the low-dose group was significantly lower than that in the high-dose group(P<0.05).【Conclusion】Olanzapine can improve depression,anxiety,somatic symptoms,and sleep quality in elderly patients with depressive disorder plus comorbid anxiety and pain.Using a low dose of olanzapine can reduce the risk of hyperglycemia and hyperlipidemia,and it has fewer adverse reactions.