帕罗西汀单用及与阿普唑仑联用治疗糖尿病合并焦虑抑郁的对照研究

摘要

OBJECTIVE:To compare the efficacy and safety of only paroxetine vs. paroxetine combined with alprazolam in the treatment of diabetes complicated with anxiety and depression. METHODS:Totally 86 patients with diabetes complicated with anxi-ety and depression were randomly divided into observation group and control group. The patients in observation group were given paroxetine 20 mg,qd,and alprazolam 0.4 mg,tid;patients in control group were given paroxetine alone. The treatment course lasted for 8 weeks in 2 groups. The clinical data was compared,including fasting plasma glucose(FPG),2 h postprandial glucose (2 h PG),glycated hemoglobin (HbA1c),cortisol,adrenocorticotropic hormone (ACTH) levels and scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD). The adverse reactions were observed. RESULTS:After treatment,FP-BG,2 h PG,HbA1c,cortisol,ACTH levels and scores of HAMA and HAMD in observation group were significantly lower than control group,with significant difference(P<0.05). There were significant differences in the incidence of adverse reactions be-tween 2 groups(P>0.05). CONCLUSIONS:Compared with paroxetine alone,paroxetine combined with alprazolam can improve more in blood glucose,endocrine levels and adverse mood symptoms in the treatment of diabetes complicated with anxiety and de-pression,with similar safety.%目的：比较帕罗西汀单用及与阿普唑仑联用治疗糖尿病合并焦虑抑郁的疗效及安全性。方法：选取糖尿病合并焦虑抑郁患者86例，随机均分为观察组和对照组。观察组患者服用帕罗西汀20 mg，qd，并服用阿普唑仑0.4 mg，tid；对照组患者单独服用帕罗西汀。两组患者疗程均为8周。比较两组患者治疗前后空腹血糖（FPG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、皮质醇、促肾上腺皮质激素（ACTH）水平及汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分，并观察不良反应情况。结果：治疗后，观察组患者FPG、2 h PG、HbA1c、皮质醇、ACTH水平及HAMA、HAMD评分均显著低于对照组及本组治疗前，差异有统计学意义（P＜0.05）。两组患者不良反应发生率比较差异无统计学意义（P＞0.05）。结论：帕罗西汀联用阿普唑仑治疗糖尿病合并焦虑抑郁相比单用帕罗西汀可更好地改善患者的血糖、内分泌水平及不良情绪，且安全性相当。