摘要
目的研究草酸艾司西酞普兰联合度洛西汀在脑卒中后抑郁患者中的治疗效果。方法90例脑卒中后抑郁患者,采用交替分组法分为对照组和观察组,各45例。对照组予以草酸艾司西酞普兰治疗,观察组在对照组基础上予以度洛西汀治疗。比较两组患者治疗效果、汉密尔顿抑郁量表(HAMD)评分、生活质量综合评定问卷-74(GQOLI-74)评分、血浆孤啡肽、5-羟色胺、匹兹堡睡眠质量指数(PSQI)评分、用药不良反应(胃肠道反应,心动过速,头晕、口干,体重增加)。结果观察组治疗总有效率95.56%高于对照组的71.11%(P<0.05)。治疗1、2、3个月,观察组患者的HAMD评分分别为(11.58±2.34)、(8.22±1.52)、(6.54±1.18)分,明显低于对照组的(15.66±3.13)、(12.11±2.33)、(9.65±2.06)分(P<0.05)。观察组患者躯体功能、心理功能、情绪状态、社会功能、认知功能评分分别为(63.51±5.82)、(64.25±6.06)、(63.24±4.66)、(61.46±2.98)、(61.34±2.87)分,均高于对照组的(53.54±5.83)、(54.38±5.87)、(55.25±5.85)、(53.87±2.69)、(52.75±2.49)分(P<0.05)。治疗后,观察组血浆孤啡肽(17.35±3.74)ng/L低于对照组的(25.72±4.65)ng/L,5-羟色胺(1.43±0.41)μmol/L高于对照组的(1.23±0.32)μmol/L(P<0.05)。治疗1、2、3个月,观察组PSQI评分分别为(11.34±2.35)、(8.27±1.53)、(6.56±1.18)分,均低于对照组的(15.64±3.16)、(12.14±2.45)、(9.67±2.09)分(P<0.05)。两组不良反应发生率比较,无统计学差异(P>0.05)。结论在脑卒中后抑郁患者的治疗中,采用草酸艾司西酞普兰联合度洛西汀,可明显减轻患者的抑郁症状,提升睡眠质量及生活质量,提高5-羟色胺水平,降低血浆孤啡肽水平,疗效好,安全性高,值得借鉴。
Objective To study the effect of escitalopram oxalate combined with duloxetine in the treatment of post-stroke depression.Methods 90 patients with post-stroke depression were selected and divided into a control group and an observation group by alternate grouping method,each with 45 cases.The control group was given escitalopram oxalate,and the observation group was combined with duloxetine on the basis of the control group.Patients in both groups were compared in terms of treatment effect,Hamilton Depression scale(HAMD)score,Generic Quality of Life Inventory-74(GQOLI-74),plasma orphanin,5-hydroxytryptamine,Pittsburgh Sleep Quality Index(PSQI)score,adverse drug reactions(gastrointestinal reactions,tachycardia,dizziness,dry mouth,weight gain).Results The total effective rate of the observation group was 95.56%,which was higher than 71.11%of the control group(P<0.05).After 1,2 and 3 months of treatment,the HAMD scores of the observation group were(11.58±2.34),(8.22±1.52)and(6.54±1.18)points,which were significantly lower than(15.66±3.13),(12.11±2.33)and(9.65±2.06)points of the control group(P<0.05).The scores of physical function,mental function,emotional state,social function and cognitive function in the observation group were(63.51±5.82),(64.25±6.06),(63.24±4.66),(61.46±2.98)and(61.34±2.87)points,which were higher than(53.54±5.83),(54.38±5.87),(55.25±5.85),(53.87±2.69)and(52.75±2.49)points in the control group(P<0.05).After treatment,the plasma orphanin of(17.35±3.74)ng/L in the observation group was lower than(25.72±4.65)ng/L in the control group,and 5-hydroxytryptamine of(1.43±0.41)μmol/L was higher than(1.23±0.32)μmol/L in the control group(P<0.05).After 1,2 and 3 months of treatment,PSQI scores in the observation group were(11.34±2.35),(8.27±1.53)and(6.56±1.18)points,which were lower than(15.64±3.16),(12.14±2.45)and(9.67±2.09)points in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the patients with post-stroke depression,escitalopram oxalate combined with duloxetine can effectively improve the depressive symptoms of the patients,improve the sleep quality and quality of life,increase the level of 5-hydroxytryptamine,and reduce the level of plasma orphanin.It has good efficacy and high safety,and is worthy of reference.
作者
张国鲁
李鑫
姬艳华
张典政
吕哲
ZHANG Guo-lu;LI Xin;JI Yan-hua(The Fourth People's Hospital of Liaocheng,Liaocheng 252000,China)
出处
《中国实用医药》
2024年第16期20-24,共5页
China Practical Medicine
