论文部分内容阅读
目的:比较度洛西汀与艾司西酞普兰治疗抑郁症的疗效和对认知功能的影响.方法:将抑郁症患者68例,分为度洛西汀组和艾司西酞普兰组各34例并治疗8周.于治疗前及治疗后采用汉密尔顿抑郁量表(HAMD-17)评定临床疗效、观察两组不良反应发生情况并采用威斯康星卡片分类测验(WCST)、连线测试(TMT)评估认知功能.结果:①治疗8周后度洛西汀组和艾司西酞普兰组的疗效比较差异无显著意义(P＞0.05),两组HAMD-17评分均显著低于治疗前(t=8.808,7.168;P＜0.05);②治疗后度洛西汀组完成分类数、正确反应数均提高,持续错误数下降,与治疗前相比差异有显著性意义(t =-3.357～4.152,P＜0.05).艾司西酞普兰组治疗后持续错误数下降,与治疗前相比差异有显著性意义(t=3.270,P＜0.05).两组治疗后比较度洛西汀组正确反应数、完成分类数均提高与艾司西酞普兰组比较有显著性差异(t =2.215,2.099;P＜0.05).两组治疗后TMT-A,TMT-B任务完成时间值分别都低于治疗前且差异有统计学意义(t=2.057～3.935;P＜0.05).治疗后两组间TMT测试结果比较,差异无统计学意义(P＞0.05);③度洛西汀组不良反应的发生率为37.5％,艾司西酞普兰组不良反应的发生率为35.5％,组间差异比较无统计学意义(P＞0.05).结论:度洛西汀与艾司西酞普兰均能够有效缓解抑郁症患者的临床症状,且不良反应率均较低.两种药物都能够改善抑郁症患者的认知功能,而度洛西汀在改善执行能力方面可能优于艾司西酞普兰.“,”Objective:To compare the clinical effect of duloxetine and escitalopram and their effect on cognitive functioning in patients with depression.Methods:A total of 68 patients with depression were randomly divided into duloxetine group and escitalopram group of 34 cases for 8 weeks.The Hamilton Depression Scale(HAMD-17)was used before and after the treatment.The adverse effects were observed.The Wisconsin Card Sorting Test(WCST)and the Connective Test(TMT) were used to assess cognitive function.Results:① There was no significant difference between the duloxetine group and escitalopram group after 8 weeks of treatment in score of HAMD-17,but it has decreased significantly compared with before treatment in the two groups (t =8.808,7.168;P ＜ 0.05).② After the treatment,the number of categories completed and the number of total correct of duloxetine group were increased and the number of perseverative errors decreased,which were significantly different from that before treatment(t =-3.357 ～ 4.152,P ＜0.05).There was a significant decrease in the number of WCST perseverative errors in the escitalopram group after treatment,which was significantly different from that before treatment (t =3.270,P ＜ 0.05).There were significant differences between the two groups in the number of categories completed and the number of total co rrect(t =2.215,2.099;P ＜ 0.05).The accomplishment time of TMT-A and TMT-B were lower in both groups than before treatment(t =2.057～3.935;P＜0.05).There were no significant differences in TMT test results between the two groups after treatment.③ The incidence of adverse reactions was 37.5％ in duloxetine group and 35.5 ％ in escitalopram group.There was no significant difference between the two groups.Conclusion:Both duloxetine and escitalopram are effective in relieving the clinical symptoms of depression,and the adverse reaction rates are low.Both drugs can improve cognitive function in depressed patients,and duloxetine may be superior to escitalopram in improving executive function.