Clinical Study on the Effect of Jiaotai Acupuncture Combined with Escitalopram on Mild Depression and Its Influence on Inflammatory Factors

[Objectives] To analyze the effect of Jiaotai acupuncture combined with Escitalopram on mild depression and its influence on inflammatory factors.[Methods] Eighty patients with mild depression admitted to Shenzhen Baoan District Central Hospital from March 2021 to March 2023 were randomly divided into observation group (40 cases) and control group (40 cases). The control group was treated with Escitalopram, and the observation group was treated with Jiaotai acupuncture on the basis of the control group. The overall efficacy, depression score before and after treatment, and the improvement of inflammation level were compared between the two groups.[Results] The total effective rate of the observation group was significantly higher than that of the control group ( P <0.05), and the improvement of depression score and inflammation level of the observation group was significantly better than that of the control group ( P <0.05).[Conclusions] Jiaotai acupuncture combined with Escitalopram can significantly reduce inflammation and improve symptoms in patients with mild depression.

Neuroprotective Effect of Escitalopram Oxalate in Rats with Chronic Hypoperfusion

Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.

Escitalopram-induced liver injury: A case report and review of literature

BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.

Clinical efficacy and safety of Guipi decoction combined with escitalopram oxalate tablets in patients with depression

BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.

Effect of escitalopram on cognitive function in depressionA mismatch negativity potentials study

We detected the event-related potential mismatch negativity （MMN） of 30 depression patients and compared to 30 age,gender,and education-matched healthy controls.Results showed that amplitudes of frequency and duration MMN were lower in depression patients compared with control patients,indicating abnormality in auditory processing （i.e.,cognitive impairment）.Following escitalopram treatment for 8 weeks,the amplitudes of frequency and duration MMN were significantly increased and Hamilton Rating Scale for Depression scores were significantly decreased in depression patients.These data suggest that escitalopram can improve cognitive function of patients with depression.Further,MMN may be a useful tool for evaluating cognitive function and treatment effects.

The Efficacy of Escitalopram Combined with Olanzapine in Depression:A Systematic Review and Meta-analysis

Background:Depression will become the second most common disease after coronary heart disease(CHD).Escitalopram and olanzapine are commonly used to treat depression.Some studies indicated that escitalopram combined with olanzapine is effective in treating depression,however,there is no evidence to support these results.Our objective was to study the efficacy of escitalopram combined with olanzapine on depression by conducting a systematic review and meta analysis,and to provide reference for doctors.Methods:Relevant evidence were searched from PubMed,SinoMed,the Cochrane Library,Web of Science,Embase,China Knowledge Resource Integrated(CNKI),Wanfang Data Knowledge Service Platform databases(WANFANG)and VIP dating from inception to July 2020.The randomized controlled trials(RCTs)of escitalopram and olanzapine for the treatment of depression was obtained.According to inclusion and exclusion criteria,two researches(Sun Wu and Wang Zhe)independently screened the literature,extracted data,and evaluated the quality of included studies.Rev Man 5.3 software was used to conduct statistical analyze.Results:A total of 39 studies involving 3,267 patients were identified.These studies were finally included into the meta-analysis.Pooled results showed that there was a significant difference in efficiency(RR=1.18,95%CI:1.14 to 1.12,P<0.00001),HAMD(MD=-4.54,95%CI:-5.09 to-3.99,P<0.00001),and HAMA(MD=-3.94,95%CI:-5.57 to-2.12,P<0.0001).There was no significant difference in adverse reactions(MD=0.07,95%CI-0.03 to 0.17,P=0.19).Heterogeneity test showed that due to the high heterogeneity of HAMD(P<0.00001,12=86%)and HAMA(P<0.00001,I2=91%),after removing the items with high heterogeneity,there were also statistically significant in HAMD(MD=-5.22,95%CI:-5.53 to-4.91,P<0.00001)and HAMA(MD=-5.46,95%CI:-6.15 to-4.77,P<0.00001).Conclusion:Based on this study,the combination of escitalopram and olanzapine was more effective in treating depression than the control group.It is suggested that clinical and scientific researchers carry out more high-quality,large-sample,multi-center RCTs to provide more evidence-based medical evidence for the future study of escitalopram combined with olanzapine in the treatment of depression.

Relief of hot flashes with escitalopram in non-depressed menopausal women in Japan: Results of a retrospective analysis

Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.

Escitalopram-induced hepatitis:A case report

BACKGROUND The antidepressant escitalopram is widely prescribed for the treatment of depression.It is generally well-tolerated,and cholestasis is not mentioned in its summary of product characteristics(Sm PC).We present a case of cholestatic and cytolysis liver injury due to escitalopram and a Vigi Base?study.CASE SUMMARY A 68-year-old man was admitted to our emergency unit due to clinical jaundice associated with hepatitis,pruritus and dark urine.We tested the patient for the most common etiologies of jaundice,including hemolysis,viral hepatitis,cirrhosis,carcinoma,cholangitis,cholelithiasis and intrahepatic or extrahepatic obstruction.The etiological study was negative,and an adverse drug reaction was the sole possible explanation.The patient was receiving treatment with escitalopram.Two days after its withdrawal,pruritus was resolved.Ten days after withdrawal,clinical jaundice disappeared.It took a month and three weeks after withdrawal for the patient to have normalized liver function tests.To our knowledge,this is the first reported case of cholestasis where treatment with escitalopram was the only possible cause,with a highly probable causality.In addition,we determined whether escitalopram is associated with hepatotoxicity and cholestasis by performing a disproportionality analysis.All cases of hepatobiliary disorders induced by escitalopram and reported in the World Health Organization pharmacovigilance database(Vigi Base?)were analyzed to characterize this toxicity.We found that patients treated with escitalopram had an increased risk of hepatitis[odds ratio(OR)=1.938(1.186-3.166)]and cholestasis[OR=1.866(1.279-2.724)][OR(95%confidence interval)].The median duration between the introduction of escitalopram and the occurrence of acute hepatitis and/or cholestasis was ten days+/-seven days.CONCLUSION Although extremely rare,this case report,the review of the literature and the pharmacovigilance update confirm that escitalopram can cause drug-induced hepatotoxicity and cholestasis,generally within a week after initiation.Thus,escitalopram should be withdrawn immediately if an iatrogenic cause cannot be excluded.If its responsibility is ascertained,escitalopram should be consequently contraindicated.In addition,serotoninergic antidepressants in patients with nonsevere depression are ineffective and harmful.Finally,the Sm PC of escitalopram should be updated to alert for this risk and give clear clinical guidelines.

Pumpkin seed ethanolic extract protects against escitalopram-induced reproductive toxicity in male mice

Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.

Pilot study of genome-wide DNA methylation and gene expression for treatment response to escitalopram in panic disorder

BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.

艾司西酞普兰治疗儿童青少年抑郁障碍的临床效果观察

目的观察艾司西酞普兰治疗儿童青少年抑郁障碍的临床效果。方法选取2022年1月—2023年12月宁夏医科大学总医院收治的100例儿童青少年抑郁障碍患者,采用随机数字表法分为两组,每组50例。对照组采用帕罗西汀治疗,观察组采用艾司西酞普兰治疗。比较两组患者的临床总有效率、治疗前后的血清神经营养因子水平、负性情绪及不良反应发生率。结果观察组临床总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组神经生长因子(NGF)和脑源性神经营养因子(BDNF)水平均高于对照组,差异有统计学意义(P<0.05);观察组汉密尔顿抑郁量表(HAMD)评分和汉密尔顿焦虑量表(HAMA)评分均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论艾司西酞普兰治疗儿童青少年抑郁障碍效果较好,能够有效提高血清神经营养因子水平,改善负性情绪,且安全性良好。

草酸艾司西酞普兰与氢溴酸伏硫西汀治疗首发抑郁症临床疗效分析

目的探讨草酸艾司西酞普兰与氢溴酸伏硫西汀治疗首发抑郁症的临床疗效与不良反应发生情况。方法70例首发抑郁症患者按照随机数字表法分为草酸艾司西酞普兰组与氢溴酸伏硫西汀组各35例,草酸艾司西酞普兰组予以草酸艾司西酞普兰口服,氢溴酸伏硫西汀组予以氢溴酸伏硫西汀口服。应用汉密尔顿抑郁量表-24(Hamilton Depression Scale-24,HAMD-24)、抑郁症症状快速自评量表(Quick Inventory of Depressive Symptomatology 16-Item Self Report,QIDS-SR16)和蒙哥马利抑郁评定量表(Montogomery Depression Rating Scale,MADRS)评估患者治疗前及治疗2、4、8周后抑郁情况。结果治疗前2组患者HAMD-24、QIDS-SR16和MADRS评分比较差异无统计学意义(P>0.05)。治疗2、4、8周后2组患者HAMD-24、QIDS-SR16和MADRS评分均较治疗前下降(P<0.05),且随治疗后时间推进,评分下降差异有统计学意义(P<0.05);治疗后同一时间点组间比较差异无统计学意义(P>0.05)。艾司西酞普兰恶心、头痛、嗜睡等不良反应发生率高于氢溴酸伏硫西汀组,差异有统计学意义(P<0.05)。结论草酸艾司西酞普兰与氢溴酸伏硫西汀治疗首发抑郁症均有显著疗效,但氢溴酸伏硫西汀不良反应更少,安全性更高。

Escitalopram with or without combined electroacupuncture on protracted alcohol withdrawal symptoms(PAWS)among male inpatients with alcohol dependence

Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.

Efficient synthesis of functionalized 1,3-dihydroisobenzofurans from salicylaldehydes:Application to the synthesis of escitalopram

An efficient synthesis of substituted 1,3-dihydroisobenzofurans is developed. In this novel route, oaroylbenzaldehydes, as key intermediates, can be obtained by lead tetraacetate oxidation of Naroylhydrazones of salicylaldehydes. The mild and general strategy enables the synthesis of various substituted 1,3-dihydroisobenzofurans in high yields. Moreover, this method can be applied to efficiently synthesize escitalopram.

甘麦大枣汤联合少阳枢机针法治疗产后抑郁临床研究

目的:观察甘麦大枣汤联合少阳枢机针法治疗产后抑郁的临床疗效。方法:将80例产后抑郁患者按照随机数字表法分为对照组39例和观察组41例。对照组给予草酸艾司西酞普兰片治疗,观察组在对照组治疗的基础上加用甘麦大枣汤联合少阳枢机针法治疗。比较两组患者的临床疗效及治疗前后神经递质水平[5-羟色胺(5-hydroxytryptamine, 5-HT)、多巴胺(dopamine, DA)]、抑郁症状评分、睡眠质量评分变化情况。结果:对照组有效率为74.36%,观察组有效率为92.68%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后5-HT、DA高于本组治疗前,观察组治疗后5-HT为(58.74±15.12)μg·L^(-1),DA为(167.91±63.15) nmol·24 h^(-1),高于对照组治疗后(P<0.05)。两组患者治疗后各项爱丁堡产后抑郁量表评分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后睡眠质量评分低于本组治疗前,观察组治疗后睡眠质量评分为(11.27±3.50)分,低于同期对照组(P<0.05)。结论:甘麦大枣汤联合少阳枢机针法治疗产后抑郁,可改善患者的抑郁症状,提高睡眠质量,其作用机制可能与调节血清中5-HT、DA水平有关。

艾司西酞普兰联合中强度有氧运动治疗轻中度抑郁症的临床效果

目的:探讨艾司西酞普兰联合中强度有氧运动治疗轻中度抑郁症的临床效果。方法:选择2023年1—12月于宜昌市优抚医院治疗的70例轻中度抑郁症患者作为研究对象,并根据随机抽签原则将入组患者分为对照组(35例)和观察组(35例)。对照组给予艾司西酞普兰治疗,观察组给予艾司西酞普兰联合中强度有氧运动治疗。比较两组临床疗效、汉密尔顿抑郁量表(HAMD-24)评分、应对方式评分及生化指标[5-羟色胺(5-HT)、去甲肾上腺素(NE)]水平。结果:与对照组(77.1%)相比,观察组治疗总有效率(94.3%)明显更高,差异有统计学意义(P<0.05)。治疗后、治疗后1个月、治疗后2个月,两组HAMD-24评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组积极应对评分、5-HT、NE水平均升高,消极应对评分均降低,且观察组积极应对评分、5-HT、NE水平高于对照组,消极应对评分低于对照组,差异有统计学意义(P<0.05)。结论:与艾司西酞普兰单一治疗相比,艾司西酞普兰联合中强度有氧运动治疗轻中度抑郁症的效果更佳,有助于缓解抑郁症状,其机制可能与改善5-HT、NE水平有关。

坦度螺酮联合艾司西酞普兰治疗青少年抑郁症合并焦虑患者的效果

目的:观察坦度螺酮联合艾司西酞普兰治疗青少年抑郁症合并焦虑患者的效果。方法:选取2022年3月至2023年8月该院收治的110例青少年抑郁症合并焦虑患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各55例。两组均进行基础治疗,在此基础上,对照组采用艾司西酞普兰治疗,研究组在对照组基础上联合坦度螺酮治疗,两组均连续治疗6周。比较两组临床疗效,治疗前后负性情绪[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]评分、神经递质[5-羟色胺(5-HT)、多巴胺(DA)]水平、睡眠质量[匹兹堡睡眠质量评定量表(PSQI)]评分、人际关系[人际关系综合诊断量表(IRAS)]评分,以及不良反应发生率。结果:研究组治疗总有效率为94.55%(52/55),高于对照组的81.82%(45/55),差异有统计学意义(P<0.05);治疗后,两组HAMA、HAMD评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组5-HT、DA水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组PSQI、IRAS评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:坦度螺酮联合艾司西酞普兰治疗青少年抑郁症合并焦虑患者可提高治疗总有效率和神经递质水平,降低负性情绪、睡眠质量和人际关系评分,效果优于单纯艾司西酞普兰治疗。

艾司西酞普兰联合天王补心丹合四物汤治疗产后抑郁症的临床效果

目的探讨艾司西酞普兰联合天王补心丹合四物汤治疗产后抑郁症的临床效果。方法选取滕州市精神卫生中心2020年2月至2022年4月收治的64例产后抑郁症患者作为研究对象,以随机数字表法分为两组,参照组(n=32)施以艾司西酞普兰治疗,研究组(n=32)在参照组基础上施以天王补心丹合四物汤治疗。对比两组治疗总有效率、不良反应(头痛、乏力、胃肠道反应、皮疹)总发生率、汉密尔顿抑郁量表(HAMD)评分、社会功能评分以及认知功能评分。结果研究组不良反应总发生率与参照组比较无差异(P>0.05)。治疗后,研究组总有效率、社会功能评分以及认知功能评分均高于参照组,HAMD评分低于参照组(P<0.05)。结论产后抑郁症患者采用艾司西酞普兰联合天王补心丹合四物汤治疗,可提升治疗效果,改善社会功能以及认知功能,促进患者良好预后。

坦索罗辛联合艾司西酞普兰治疗慢性骨盆疼痛综合征的疗效观察

目的分析坦索罗辛联合艾司西酞普兰治疗慢性骨盆疼痛综合征的临床疗效、症状改善和炎症水平的影响。方法选取2022年1月至2023年1月收治的慢性骨盆疼痛患者120例作为研究对象(参考Kendall样本量估计方法,样本量:观察变量的10~20倍,预计估算量:60~120个),随机数表法分为对照组和观察组,每组60例。对照组给予坦索罗辛治疗,观察组给予坦索罗辛联合艾司西酞普兰治疗,疗程均为2个月。比较2组患者治疗前、后的排尿症状、炎性因子水平、临床指标和症状积分变化情况,对比2组患者的不良反应发生情况。结果观察组患者的尿频尿急、尿后滴沥、排尿疼痛评分和总积分均低于对照组(P<0.05);观察组治愈率显著高于对照组(P<0.05);观察组白细胞计数(WBC)、白介素-1β(IL-1β)、干扰素-α(INF-α)均低于对照组,平均尿流率(AFR)、白细胞介素-2(IL-2)均高于对照组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论坦索罗辛联合艾司西酞普兰治疗慢性骨盆疼痛综合征有助于改善临床症状和临床指标、抑制炎性反应,临床疗效较好。

基于临床症状和生物学特征预测电针抗抑郁临床疗效的探索性分析

目的探索影响轻中度抑郁症患者对电针、药物和针药联合3种不同干预措施应答的关键因素。方法将61例轻中度抑郁症患者随机分为电针组(20例,脱落1例)、药物组(20例,脱落4例)和针药联合组(21例,脱落1例)。电针治疗选取主穴百会、印堂并接电,每次30 min,每周3次;药物治疗口服草酸艾司西酞普兰,5~10 mg/d;针药联合组的患者同时接受电针和药物治疗,治疗均持续6周。观察患者抑郁严重程度、生活质量等临床表现,ELISA法检测3组患者血清相关指标表达水平。结果治疗后,3组患者,24项汉密尔顿抑郁量在(24-item Hamilton depression scale,HAMD-24)评分均显著下降(P<0.05),3组患者,健康状况调查问卷(short form 36 health survey,SF-36)评分均显著提高(P<0.05)。3组患者的HAMD-24应答率、缓解率、SSRS、SF-36评分差异无统计学意义(P>0.05)。结合临床症状和分子生物学指标模拟的模型较为可靠。结论适合不同干预措施的轻、中度抑郁症患者人群基本特征有所不同。对伴随较严重睡眠障碍的抑郁症患者,选择针药联合治疗更有可能取得较好的临床疗效。