马来酸氟伏沙明治疗脑卒中后抑郁患者的对照研究

摘要

Objective:To compare efficacy and safety of Fluvoxamine maleate and Amitriptyline in treatment of post-stroke depression. Methods:60 patients with post-stroke depression meeting the diagnostic criteria were divided into Fluvoxamine maleate group and Amitriptyline group and treated for 6 weeks, respectively. The efficacies and side effects were evaluated with Hamilton de-pression scale (HMAD) and treatment emergent symptom scale (TESS) before and 2, 4, and 6 weeks after the treatment. The blood routine examination, liver function and renal function tests, and electrocardiogram were done before and 2, 4, and 6 weeks after the treatment. Results:There was no difference in efficacy between the two groups (P>0. 05). 2, 4, and 6 weeks after the treatment, the HAMD scores of Fluvoxamine maleate group and Amitriptyline group both decreased obviously than those before the treatment ( both P<0. 01), and the difference between the two groups was not significant (P>0. 05). The side effects of Fluvoxamine maleate group were less than those of Amitriptyline group, and the difference between the two groups was statistically significant (P<0. 01). Conclusions:Fluvoxamine maleate in anti-depression is similar to Amitriptyline in the efficacy;however, the side effects of Fluvoxamine maleate are less than those of Amitriptyline. Fluvoxamine Maleate has a good compliance and tolerance, and can be used as a referred drug in the treatment of post-stroke depression.%目的：比较马来酸氟伏沙明与阿米替林治疗脑卒中后抑郁患者的疗效和安全性。方法：符合诊断标准的脑卒中后抑郁患者共60例,随机分为两组,分别应用马来酸氟伏沙明和阿米替林治疗6周,采用汉密尔顿抑郁量表(HAMD)和副反应量表(TESS)于患者治疗前和治疗后2、4、6周分别评定疗效和不良反应,并于治疗前和治疗后2、4、6周分别检查患者血常规、肝功能、肾功能和心电图。结果：两组患者疗效无显著差异(P>0.05),马来酸氟伏沙明组和阿米替林组患者治疗后2、4、6周,HAMD评分均较治疗前显著下降(P均<0.01),两组患者间比较差异无显著性(P>0.05)。马来酸氟伏沙明组患者的不良反应较阿米替林组少而轻,两组间比较有统计学意义(P<0.01)。结论：马来酸氟伏沙明抗抑郁的作用显著,疗效与阿米替林相仿,患者的不良反应较阿米替林少且程度轻,具有良好的依从性和耐受性,可作为治疗脑卒中后抑郁首选药物。