CAJ | 학술논문

目的探讨加用阿立哌唑与换用文拉法辛对选择性5-羟色胺再摄取抑制剂(SSRI)类药物治疗抵抗抑郁症的疗效及安全性.方法 84例SSRI类药物系统治疗后未见显著疗效的抑郁症患者按随机数字表法分为增效组42例和换药组42例.增效组在原治疗方案的基础上加用阿立哌唑(9 ± 5)mg/d治疗 ,换药组在停用原治疗药物后改用文拉法辛(154 ± 47)mg/d治疗 ,疗程均为8周.采用汉密尔顿抑郁量表(HAMD-24)和大体评定量表(GAS)评定疗效 ,以治疗前后HAMD-24减分率≥50% 作为判定显效率的依据 ;采用副反应量表(TESS)评价治疗的安全性.结果治疗8周后 ,2组患者HAMD-24评分均较治疗前显著减少(P<0.01) ,GAS评分均较治疗前显著增加(P< 0.01).2组患者治疗8周后 HAMD-24评分及 GAS评分差异均无统计学意义(P>0.05).增效组治疗显效率为52% ,换药组57% ,组间差异无统计学意义(P>0.05).2组不良反应均较轻微 ,总体发生率差异无统计学意义(P>0.05).结论阿立哌唑增效与换用文拉法辛治疗对SSRI类药物治疗抵抗抑郁症均有一定疗效 ,2种方案的治疗效果及安全性基本相当.
목적 탐토가용아립고서여환용문랍법신대선택성5-간색알재섭취억제제(SSRI)류약물치료저항억욱증적료효급안전성.방법 84례SSRI류약물계통치료후미견현저료효적억욱증환자안수궤수자표법분위증효조42례화환약조42례.증효조재원치료방안적기출상가용아립고서(9 ± 5)mg/d치료 ,환약조재정용원치료약물후개용문랍법신(154 ± 47)mg/d치료 ,료정균위8주.채용한밀이돈억욱량표(HAMD-24)화대체평정량표(GAS)평정료효 ,이치료전후HAMD-24감분솔≥50% 작위판정현효솔적의거 ;채용부반응량표(TESS)평개치료적안전성.결과 치료8주후 ,2조환자HAMD-24평분균교치료전현저감소(P<0.01) ,GAS평분균교치료전현저증가(P< 0.01).2조환자치료8주후 HAMD-24평분급 GAS평분차이균무통계학의의(P>0.05).증효조치료현효솔위52% ,환약조57% ,조간차이무통계학의의(P>0.05).2조불량반응균교경미 ,총체발생솔차이무통계학의의(P>0.05).결론 아립고서증효여환용문랍법신치료대SSRI류약물치료저항억욱증균유일정료효 ,2충방안적치료효과급안전성기본상당.
Objective To investigate the curative effect and safety of aripiprazole augmentation and ven-lafaxine in treatment of selective serotonin reuptake inhibitors(SSRIs) treatment-resistance depression .Methods Eighty-four patients with SSRIs treatment-resistance depression were randomly assigned into two group:42 in aug-mentation group and 42 in switching group .The augmentation group were treated with aripiprazole (9 ± 5)mg/d combined with the original SSRIs treatment and the control group with venlafaxine(154 ± 47)mg/d ,and treatment course was 8 weeks .Hamilton Depression Scale (HAMD-24) and Global Assessment Scale (GAS) were used to evaluate the curative effect ,and the reducing score rate of HAMD-24≥50% was significant advancement .Treat-ment Emergent Symptom Scale(TESS) was used to evaluate the safety .Results At the end of week 8 ,the scores of HAMD-24 of the two groups were lower than those before the treatment(P<0.01) ,and the scores of GAS were higher than those before the treatment(P<0.01) .At the end of week 8 ,there were no significant difference between the scores of HAMD-24/GAS of the two groups(P>0.05) .The apparent rate of the augmentation group and switching group were 52% and 57% respectively ,and there was no significant difference(P>0.05) .Adverse reactions of the two groups were milder ,and there were no significant differences in the overall incidence .Conclu-sion The strategies of aripiprazole augmentation and switching to venlafaxine are both effective for SSRI treat-ment-resistance depression. T heir efficacy and safety are approximately equivalent .