二甲双胍联合阿戈美拉汀对围绝经期女性2型糖尿病共病抑郁临床疗效及卵巢功能的影响

Effects of Metformin Combined with Agomelatine on the Clinical Efficacy and Ovarian Function of Perimenopausal Female Patients with Type 2 Diabetes Mellitus and Comorbid Depression

目的探讨二甲双胍联合阿戈美拉汀对围绝经期女性2型糖尿病共病抑郁临床疗效及卵巢功能的影响。方法选择围绝经期女性2型糖尿病共病抑郁患者200例,时间在2017年1月至2019年12月,随机数字表法分为对照组和研究组,每组100例,2组均使用二甲双胍治疗,对照组联合文拉法辛治疗,研究组联合阿戈美拉汀治疗。比较2组治疗前后睡眠状况、抑郁评分、卵巢功能、生活质量评分、血糖水平变化情况以及安全性。结果治疗后,研究组匹兹堡睡眠指数4个维度评分、空腹血糖、餐后2 h血糖均低于治疗前及对照组(P<0.05)。与对照组比较,研究组治疗7、21、42 d时汉密尔顿抑郁量表评分均更低(P<0.05)。治疗后,研究组雌二醇水平、生活质量综合评定问卷4个维度评分均高于治疗前及对照组(P<0.05);2组黄体生成素、卵泡刺激素水平比较无差异(P>0.05)。与对照组比较,研究组不良反应总发生率更低(P<0.05)。结论二甲双胍联合阿戈美拉汀治疗围绝经期女性2型糖尿病共病抑郁,能够在不影响患者卵巢功能的前提下,明显缓解抑郁情绪、改善睡眠状况,其安全性、临床效果优良。

Objective To investigate the effect of Metformin combined with Agomelatine on clinical efficacy and ovarian function of perimenopausal patients with type 2 diabetes mellitus(T2DM)and comorbid depression.Methods A total of 200 perimenopausal female patients with T2DM and comorbid depression were selected from January 2017 to December 2019.They were divided into control group and research group by random number table method,with 100 patients in each group.Both groups were treated with Metformin,the control group was supplemented with Venlafaxine and the research group was supplemented with Agomelatine.The changes in sleep status,depression score,ovarian function,quality of life score,blood glucose level and safety of the two groups were compared before and after treatment.Results After treatment,the scores of Pittsburgh sleep quality index,fasting blood glucose and 2 h postprandial blood glucose in the research group were lower than those before treatment and those in the control group(P<0.05).Compared with the control group,the Hamilton Depression Scale scores of the research group were lower at 7,21 and 42 d after treatment(P<0.05).After treatment,estradiol level and quality of life comprehensive assessment questionnaire scores in the research group were higher than those before treatment and in the control group(P<0.05).There were no differences in luteinizing hormone and follicle stimulating hormone levels between the two groups(P>0.05).The total incidence of adverse reactions in the research group was lower than that in the control group(P<0.05).Conclusion The use of Metformin combined with Agomelatine in the treatment of perimenopausal female patients with T2DM and comorbid depression can significantly alleviate depression and improve the patients'sleep status,without affecting their ovarian function,and its safety and clinical effects are excellent.