文拉法辛联合认知心理治疗对难治性抑郁症的疗效

Therapeutic effect of Venlafaxine combined with cognitive psychotherapy on refractory depression

目的探讨文拉法辛合并认知心理治疗对难治性抑郁症的治疗效果,为临床难治性抑郁症治疗提供有效依据。方法选取2013年2月—2017年2月110例难治性抑郁症患者作为研究对象,依据随机数字表法分为对照组和联合组,每组55例。其中,对照组采用文拉法辛进行治疗,联合组采用文拉法辛联合认知心理治疗。比较两组治疗总有效率,患者用药依从性评分;治疗前、后患者17项汉密尔顿抑郁量表评分、14项汉密尔顿焦虑量表评分、SF-36生活质量评分及用药不良反应发生率。结果联合组难治性抑郁症治疗总有效率(96.36%)高于对照组(76.36%),差异有统计学意义(P<0.05);治疗前,联合组与对照组17项汉密尔顿抑郁量表评分[(27.34±2.25)分vs.(27.25±2.21)分]、14项汉密尔顿焦虑量表评分[(25.54±3.56)分vs.(25.55±3.71)分]、SF-36生活质量评分[(53.73±5.65)分vs.(52.02±5.66)分]相近,差异无统计学意义(P>0.05);治疗后,联合组17项汉密尔顿抑郁量表评分(12.78±0.32)分及14项汉密尔顿焦虑量表评分(11.21±0.51)分低于对照组,SF-36生活质量评分(94.25±6.61)分高于对照组,差异有统计学意义(P<0.05);两组均无明显用药不良反应发生。结论文拉法辛合并认知心理治疗对难治性抑郁症的治疗效果确切,可弥补单一用药的缺陷,提高患者治疗依从性和治疗效果,减轻患者焦虑抑郁症状,提高其生活质量。

Objective To investigate the therapeutic effect of Venlafaxine combined with cognitive psychotherapy on refractory depression for providing the basis of clinical treatment. Methods A total of110 patients with refractory depression were enrolled from February 2013 to February 2017, and divided into control group and combination group according to the number table, each 55 cases. The control group was treated with Venlafaxine, and the combination group was treated with Venlafaxine and cognitive therapy. The indexes such as total effective rate, medication compliance score, 17 articles of Hamilton depression scale score, 14 articles of Hamilton anxiety scale, SF-36 life quality score and incidence of adverse drug reactions, were compared. Results The total effective rate was significantly higher in the combination group(92.36%) than that in the control group(76.36%), the difference was significant(P<0.05). Before treatment, the scores of the 17 articles of Hamilton Depression Scale in the combination group and the control group was(27.34±2.25),(27.5±2.21), respectively,scores of 14 articles of Hamilton anxiety scale was(25.54± 3.56),(25.55± 3.71), respectively, and SF-36 quality of life score was(53.73±5.65),(52.02±5.66), respectively, and there were no significant difference between the two groups(all P>0.05). After therapy, compared to the control group, the 17 articles of Hamilton Depression Scale and the 14 articles of Hamilton Anxiety Scale scores were all lower in the combination group[(21.29 ± 0.69) vs.(21.29 ± 0.69),(11.21 ± 0.51) vs.(16.92±2.25), all P<0.05) ], but the SF-36 quality of life score was higher than that of the control group[(94.25 ± 6.61) vs.(80.14 ± 5.62), P<0.05]. There was no significant adverse effect in both groups. Conclusion Venlafaxine combined with cognitive psychotherapy is effective in the treatment of refractory depression, which can compensate the defects of single medication, improve the patient's compliance and treatment effect, reduce the symptoms of anxiety and depression and improve the quality of life.