坦度螺酮對米那普侖治療抑郁癥的增效作用對照研究

徐麗莉　李春陽　劉俊賢　胡敏儀

【摘要】 目的：探討坦度螺酮對米那普侖治療抑郁癥患者的增效作用，為臨床優化治療提供依據。方法：選取2017年11月-2018年6月本院60例抑郁癥患者，按隨機數字表法分為聯用組與單用組，每組30例，聯用組用坦度螺酮聯合米那普侖治療，單用組單用米那普侖治療，兩組均治療8周。應用漢密頓抑郁量表（HAMD）、漢密頓焦慮量表（HAMA）評定療效，副反應量表（TESS）評定安全性和不良反應。結果：治療前兩組HAMD與HAMA評分比較，差異均無統計學意義（P>0.05）;治療2、4、8周，聯用組HAMD及HAMA評分均低于單用組（P<0.01）。聯用組顯效率高于單用組（P<0.05）。兩組不良反應發生率比較，差異無統計學意義（P>0.05）。結論：坦度螺酮聯合米那普侖治療抑郁癥的效果好于單獨應用米那普侖治療。

【關鍵詞】 抑郁癥; 米那普侖; 坦度螺酮

Comparative Study on the Synergistic Effect of Tandospirone on the Treatmen of Depression with Milnacipran/XU Lili，LI Chunyang，LIU Junxian，et al.//Medical Innovation of China，2019，16（22）：0-041

【Abstract】 Objective：To investigate the synergistic effect of Tandospirone on the treatment of depression patients with Milnacipran，and to provide evidence for clinical optimal treatment.Method：60 patients with depression in our hospital from November 2017 to June 2018 were selected and divided into combined group and alone group according to the random number table method，30 cases in each group.The combined group was treated with Tandospirone combined with Milnacipran，the alone group was treated with Milnacipran alone，both groups were treated for 8 weeks.The efficacy was assessed by Hamilton depression scale（HAMD）and Hamilton anxiety scale（HAMA），the safety and adverse reactions were assessed by treatment emergent symptom scale（TESS）.Result：There were no significant differences in HAMD and HAMA scores between the two groups before treatment（P>0.05）.At the 2，4，8 week of treatment，HAMD and HAMA scores of the combined group were lower than those of the alone group（P<0.01）.The marked effective rate of the combined group was higher than that of the alone group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：The effect of Tandospirone combined with Milnacipran in the treatment of depression is better than that of Milnacipran alone.

【Key words】 Depression; Milnacipran; Tandospirone

First-authors address：Shunde Wuzhongpei Memorial Hospital of Foshan City in Guangdong Province，Foshan 528300，China

doi：10.3969/j.issn.1674-4985.2019.22.010

抑郁癥是一種常見的精神疾病，主要臨床特征是思維遲緩、心境低落、意志活動減退等癥狀，嚴重的患者可出現自殺觀念及行為。通常情況下，抑郁與焦慮是并存的，國內外相應研究發現60%～90%的抑郁癥人群同時伴有焦慮癥狀[1]。抗抑郁藥一般同時具有抗抑郁和抗焦慮的雙重作用，被廣泛用于抑郁癥的治療，但抗抑郁藥不管是SSRIs類藥物還是SNRI類藥物，均存在起效慢、療效不夠理想的缺點[2]。國外文獻報道，坦度螺酮作為一種新型抗焦慮藥，近年來開始有研究表明，其可增強抑郁癥患者抗抑郁藥的效果[3]。國內已有文獻報道坦度螺酮聯合SSRI類抗抑郁藥有提高抑郁癥的療效、縮短起效時間的優點[4-5]。本研究探討應用坦度螺酮合用米那普侖治療抑郁癥的療效和安全性，國內外文獻報道較少，旨在為抑郁癥的優化治療提供更多選擇，現報道如下。