舍曲林与帕罗西汀治疗首发老年期抑郁症患者的对照研究

摘要

目的 探讨舍曲林与帕罗西汀治疗首发老年期抑郁症患者的临床疗效.方法 选取我院2009年11月～2011年12月收治的首发老年期抑郁症患者70例,按入院先后顺序分为舍曲林组(100～175 mg/d)和帕罗西汀组(20～40 mg/d),疗程均为8周,治疗前后以汉密尔顿抑郁量表17项(HAMD-17),记录不良反应及实验室情况.结果 在治疗第1、2、4、6、8周两组治疗总有效率比较,差异无统计学意义(P ＞ 0.05).治疗后舍曲林组与帕罗西汀组焦虑/躯体化因子、认知障碍因子、体质量因子、睡眠障碍因子、阻滞因子、HAMD-17总评分均明显下降,治疗前后差异均有统计学意义(P ＜ 0.05),舍曲林组与帕罗西汀组间相比较,差异均无统计学意义(P ＞ 0.05).两组患者在治疗前后无血生化、血常规、心电图的明显异常.舍曲林组的不良反应发生率明显低于帕罗西汀组,差异有统计学意义(P ＜ 0.05).结论 舍曲林与帕罗西汀治疗首发老年抑郁症均具有显著的临床疗效,但舍曲林起效的不良反应发生率较低,更适合于患者长期服用.%Objective To investigate the clinical efficacy of Sertraline and Paroxetine in the treatment of elderly patients with first episode of depression. Methods 70 elderly patients with first episode of depression were selected in our hospital from November 2009 to December 2011. According to the sequence of admission, patients were divided into Sertraline group (100-175 mg/d ) and Paroxetine group (20-40 mg/d). Course of treatment was 8 weeks. Hamilton depression rating scale of 17 (HAMD-17) was performed before and after treatment. Adverse reactions and lab were recorded. Results In the treatment of 1, 2, 4, 6, 8 weeks, the difference of the effective rate in the two groups were not statistically significant (P > 0.05). After treatment, anxiety/somatization factor, cognitive factor, quality factor, sleep disturbance factor, retardation factor, total score of HAMD-17 in the Sertraline group and Paroxetine group were decreased significantly, the difference was statistically significant (P < 0.05). There were no significant differences between Sertraline group and Paroxetine group (P >rn0.05). There were no blood biochemistry, blood routine examination,electrocardiographic abnormality in two groups beforernand after treatment. The incidence of adverse reactions in the Sertraline group was significantly lower than the Paroxetine group, the difference was statistically significant (P < 0.05). Conclusion Sertraline and Paroxetine in the treatment for first episode of depression in the elderly has significant clinical efficacy. But adverse reaction rate of Sertraline is low. Sertraline is more suitable for the patients with long term use.