舍曲林与阿米替林治疗抑郁症对照研究

摘要

目的 探讨舍曲林与阿米替林治疗抑郁症的临床疗效及安全性. 方法 将52例抑郁症患者随机分为两组,研究组口服舍曲林治疗,对照组口服阿米替林治疗,观察6 w.于治疗前及治疗第1 w、2 w、4 w、6 w末采用汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效,副反应量表评定不良反应. 结果 治疗6 w末,研究组显效率88.46%,总有效率92.31%;对照组分别为53.85%和69.23%.研究组显著高于对照组(P＜0.05).治疗后两组汉密顿抑郁量表、汉密顿焦虑量表总分随着治疗时间的延续均呈持续性下降;同期研究组均较对照组下降显著,汉密顿抑郁量表总分治疗6 w末有极显著性差异(P＜0.01);汉密顿焦虑量表总分治疗1 w、2 w末有显著性差异(P＜0.05),4 w、6 w末有极显著性差异(P＜0.01).研究组不良反应发生率显著低于对照组,且程度较轻微. 结论 舍曲林具有抗抑郁、抗焦虑双重作用,治疗抑郁焦虑效果显著,且起效快,显著优于阿米替林治疗,安全性更高,依从性更好,值得临床推广应用.%Objective To explore the efficacy and safety of sertraline vs amitriptyline in the treatment of depression. Methods 52 depression patients were rndomly divided into two groups,research group took orally sertraline and control group did amitriptyline for 6 weeks.Efficacies were assessed with the Hamilton Depression Scale( HAMD) and Hamilton Anxiety Scale(HAMA) and adverse reactions with the Treatment Emergent Symptom Scale(TESS) before treatment and at the end of the 1st,2nd,4th and 6th week treatment. Results At the end of the 6th week, obvious and total effective rates were 88.46% and 92.31% in the research and 53.85% and 69.23% in the control group,which showed significant differemces(P<0.05).After treatment,total scores of the HAMD and HAMA of both groups lowered continously with treatment;those lowered more significantly in the research than in the control group during the corresponding time period,but at the end of the 6th week total score of the HAMD had very significant difference(P<0.01);total scores had significant differences at the end of the 1st and 2nd week(P<0.05) and very significant at the end of the 4th and 6th week(P<0.01).The incidences of adverse reactions were significantly lower and those milder in the reasearch than in the control group. Conclusion Sertraline has dual effects of antidepression and antianxiety, evident effects on depression-anxiety,takes effects faster,has higher safety and better compliance than amitriptyline,merits clinical generalization and application.