丁螺环酮与阿米替林治疗伴焦虑症状的抑郁症对照研究

ntrolled studies of buspirene and amitriptyline in the treatmant of depression with anxiety symptoms

目的 评价丁螺环酮和阿米替林治疗伴焦虑症状抑郁症的临床疗效及副反应。方法按投币法随机将58例伴焦虑症状抑郁症患者分为丁螺环酮组和阿米替林组,其中脱落8例,资料完整者50例。丁螺环酮组(甲组)25例,其中男11例,女14例,年龄18～59a,平均29.5±9.77a;阿米替林组(乙组)25例,男10例,女15例,年龄18～54a,平均29.8±11.54a。两组患者的一般情况用t检验。甲组患者服用丁螺环酮,初始剂量10mg·d～1,视病情及躯体情况渐增加剂量,最高剂量80mg·d～1。乙组患者服用阿米替林,初始剂量50mg·d～1,视病情及躯体情况渐增加剂量,最高剂量250mg·d-1。疗程均为6w。疗效观察指标:(1)治疗前后分别进行汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、副反应量表(TESS)评定,各量表均由两名高年资精神科医师共同评定,总体疗效按痊愈、显进、进步和无效或恶化4级评定(其中痊愈加显进为显效,显进加进步为有效)。评定标准为量表减分率>75％为显效,50～75％为进步,<25％为无效,在治疗前及治疗后各进行血常规、尿常规、肝功能、心电图、肾功能检查。结果丁螺环酮治疗抑郁症状的疗效与阿米替林相似,治疗焦虑症状的疗效优于阿米替林,且副作用小。结论对于伴有焦虑症状的抑郁症患者,丁螺环酮可作为首选药物。

Objective To estimate the clinical effectiveness and side effects of buspirone and amitriptyline in the treatment of depression with anxity symptoms. Methods Eight of 58 depressive in - patients with anxity symptoms droped out and the other 50 were ramdomly assigned to receive buspirone ( Group A; n = 25, male 11 and female 14; mean age 29.5 ± 9.77a) or amitriptyline ( Group B; n = 25, male 10 and female 15; mean age 29.8 ± 11.54) for 6 weeks. The HAMA, HAMD and Tess were used to evaluate the effectiveness and side effects before and after the treatment. Results Buspirone had similar effectiveness to amitriptyline in the treatment of depression. But the former had better effectiveness and less side effects than the latter did in anxiety disorder. Conclusion It is suggested that busspirone is the best drug in the trentment of depression with anxiety symptoms.