丁螺环酮与文拉法辛缓释片联合治疗脑卒中后中重度抑郁的临床观察

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1、丁螺环酮与文拉法辛缓释片联合治疗脑卒中后中重度抑郁的临床观察河南省精神卫生屮心河南新乡453002【摘要】目的比较丁螺环酮与文拉法辛缓释片联用治疗脑卒屮后屮重度抑郁与文拉法辛缓释片治疗的疗效及安全性。方法选择脑卒屮后屮重度抑郁患者70例，随机分为两组各35例。研究组采用丁螺环酮与文拉法辛缓释片联合治疗，对照组单用文拉法辛缓释片，观察疗程均为8周，定期对患者采用HAMD(24项)抑郁量表与TESS副反应量表进行疗效评估。结果研宂组临床疗效总有效率为94.3%(33/35),显著优于对照组的74.3%(26/35)(P<0.05)。两组治疗后HAMD评定，治疗第1周开始较治疗

2、前有统计学意义，且一直持续至观察第8周，并研宄组较对照组亦有统计学意义(P<0.05)o两组治疗期间副反应无统计学意义。结论文拉法辛缓释片联用丁螺环酮治疗脑卒屮后抑郁较单用文拉法辛缓释片治疗疗效显著，安全性高。【关键词】脑卒屮后抑郁；丁螺环酮；文拉法辛缓释片ClinicalObservationPost-strokeDepressionbyBuspironeCombinedwithVenlafaxinehydrochloridesustained-releasetabletsYUANFu-qiang,HanYan，YuHong-yan,XuYa-nan,PANMiaoDe

3、partmentofPsychiatry,HenanMentalHealthCenter,Xinxiang453002Correspondingauthor：PANMiao,panmiao@yeah.net[Abstract]ObjectiveTocomparetheeffectandsafetyofBuspironecombinedwithVenlafaxinehydrochloridesustained-releasetabletsandVenlafaxinehydrochloridesustained-releasetabletsusedsinglyinthetreatm

4、entofPost-strokeDepression.MethodsTotallythe70post-strokedepressionpatientswererandomizedintoacontrolgroup(n=35),treatedwithVenlafaxinehydrochloridesustained-releasetablets,andastudygroup(n=35)，treatedbyBuspironecombinedwithVenlafaxinehydrochloridesustained-releasetablets.Theobservationlaste

5、d8weeks.ThetherapeuticeffectandsafetywereevaluatedbythepositiveandnegativesyndromescaleHAMD(24items),andtreatmentemergentsymptomscaleTESS.ResultsAccordingtotherateofHAMDtotalscoressubtraction，totaleffectiverateofthestudygroupwas94.3%(33/35)andofthecontrolgroup74.3%(26/35)，thereexsistedasigni

6、ficantdifference(P<O.O5)afterthetreatmentin1stweekend，andcontinuingto8thweekend，andthereexsistedasignificantdifferenceintwogroups(P<0.05).ConclusionBuspironecombinedwithVenlafaxinehydrochloridesustained-releasetabletsiseffectiveandsafeinthetreatmentofpost-strokedepression.[Keywords]Pos

7、t-strokeDepression，Buspirone，Venlafaxinehydrochloridesustained-releasetablets脑卒中后抑郁(post-strokedepression,PSD)是脑卒中患者的常见并发症，也是老年期常见的精神疾病，严重影响老年人身心健康、生活质量。丁螺环酮用于抗抑郁的辅助治疗，其对5-HT1A受体具有高度的选择性[1】，而文拉法辛是一种新型的抗抑郁药，能冋吋抑制神经细胞摄取5-HT和NE，增加脑内这两种递质的浓度水平，发挥抗抑郁作用，