CAJ | 학술논문

目的：探讨丁螺环酮联合草酸艾司西酞普兰治疗抑郁症的增效作用和安全性。方法选取符合ICD-10抑郁发作诊断标准，经草酸艾司西酞普兰足量（20mg/d）、足疗程（6周）治疗未获得痊愈的45例抑郁症患者，加用丁螺环酮15~60mg/d，观察8周，并分别在治疗前、治疗后第1、4、8周末分别评估汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA），以第1周末HAMA评分≤7分为界，分为焦虑控制组（HAMA评分≤7分）和焦虑未控制组（HAMA评分＞7分）；以8周末HAMD≤7分为标准，分为获得痊愈组（HAMD≤7分）和未获得痊愈组（HAMD＞7分）；并在治疗第1、4、8周末分别评估不良反应。结果在治疗第4周，获得痊愈20例（44.4%），第8周末获得痊愈25例（55.5%）。治疗后第4、8周，获得痊愈组的患者HAMA评分明显低于未获得痊愈组（P＜0.05）。治疗后第1、4周，焦虑控制组和焦虑未控制组患者HAMD评分比较差异无统计学意义，治疗后第8周，两组患者HAMD评分比较差异有统计学意义（P＜0.05）。不良反应以口干（40.0%）、便秘（36.9%）及乏力（13.3%）为多见。结论经草酸艾司西酞普兰足量、足疗程治疗后仍未彻底痊愈的患者加用丁螺环酮可进一步获得疗效，提高痊愈率,安全性良好。
목적：탐토정라배동연합초산애사서태보란치료억욱증적증효작용화안전성。방법선취부합ICD-10억욱발작진단표준，경초산애사서태보란족량（20mg/d）、족료정（6주）치료미획득전유적45례억욱증환자，가용정라배동15~60mg/d，관찰8주，병분별재치료전、치료후제1、4、8주말분별평고한밀이돈억욱량표（HAMD）화한밀이돈초필량표（HAMA），이제1주말HAMA평분≤7분위계，분위초필공제조（HAMA평분≤7분）화초필미공제조（HAMA평분＞7분）；이8주말HAMD≤7분위표준，분위획득전유조（HAMD≤7분）화미획득전유조（HAMD＞7분）；병재치료제1、4、8주말분별평고불량반응。결과재치료제4주，획득전유20례（44.4%），제8주말획득전유25례（55.5%）。치료후제4、8주，획득전유조적환자HAMA평분명현저우미획득전유조（P＜0.05）。치료후제1、4주，초필공제조화초필미공제조환자HAMD평분비교차이무통계학의의，치료후제8주，량조환자HAMD평분비교차이유통계학의의（P＜0.05）。불량반응이구간（40.0%）、편비（36.9%）급핍력（13.3%）위다견。결론경초산애사서태보란족량、족료정치료후잉미철저전유적환자가용정라배동가진일보획득료효，제고전유솔,안전성량호。
Objective To investigate the enhancing effects and safety of buspirone in combination with escitalopram for patients with depression. Methods Forty eight depressive patients with incompleted recovery after administration of esci-talopram (20mg/d) over 6 weeks were enrol ed in the study. Patients received buspirone(15- 60mg/d) along with an optimal dose of escitalopram for 8 weeks.Patients were evaluated with Hamilton Depression Scale (HAMD- 17) and Hamilton Anxiety Scale (HAMA- 14) at the end of 1st, 4th and 8th week, Adverse effects were assessed with Treatment Emergent Symptom Scale (TESS) at the end of 1st, 4th and 8th week. By the end of week 8, patients were grouped in A (Remission:HAMD≤7) and B (Non- remis-sion:HAMD≥7), While by the end of week 1, patients were grouped in C (HAMA≤7) and D (HAMA≥7), Results Of 48 en-rol ed patients, 45 patients completed the study while the remaining 3 dropped out. At the end of the 4th week, 20 patients (44.4%) achieved recovery and by the end of 8th week, 25 patients(55.5%) achieved recovery. The study group scored lower than the control in the HAMA score (P<0.05). Anxiety patients with signs of recovery at week 1 (HAMA≤7) obtained a lower HAMD score at week 4 and 8 (P<0.05). The adverse effects included xerostomia(40%), constipation (36.9%) and fatigue(13.3%). Most of patients were tolerated wel til the end of the study and no participants drop out due to the adverse effects. Conclusion Depres-sive patients treated with buspirone along with escitalopram may obtain better recovery with the safety.