Objective To investigate the effect of fluoxetine hydrochloride combined with risperidone in treating patients with refractory depression and its influence on sleep quality, which aimed to provide a reference for the effective treatment of refractory depression.Methods Based on International Classification of Diseases, tenth edition (ICD-10), 92 patients with refractory depression were enrolled in the Xinjiang Uygur Autonomous Region People's Hospital from January 2015 to October 2016.They were divided into fluoxetine hydrochloride group (control group) and fluoxetine hydrochloride combined with risperidone group (observation group) with each 46 cases through the random number table method.Both groups were treated for 8 weeks.Before and after treatment, the Hamilton Depression Scale-17 item (HAMD-17) was used to assess the efficacy, the sleep quality was assessed by the Pittsburgh Sleep Index Scale (PSQI), and the self-made adverse events were used to record the adverse effects.Results After 8 weeks of treatment, the total effective rate of the observation group was higher than that of the control group(93.5% vs.78.3%,χ2=4.39, P<0.05).The HAMD-17 score in the observation group was lower than that in the control group[(13.2±2.8) vs.(16.3±3.4), t=4.77, P<0.01].The PSQI score was lower than the control group[(10.2±1.2) vs.(12.1±1.4), t=6.99, P<0.01].There was no significant difference in the incidence of adverse reactions between the two groups(6.5% vs.13.0%, χ2=0.49, P=0.48).Conclusion Fluoxetine hydrochloride and fluoxetine hydrochloride combined with risperidone can improve the clinical symptoms and sleep quality of refractory depression, but the combined effect is better than fluoxetine hydrochloride alone, the two are quite safe.%目的 探讨盐酸氟西汀联合利培酮治疗难治性抑郁症临床效果及对患者睡眠质量的影响,为难治性抑郁症的治疗提供参考.方法 选取2015年1月-2016年10月就诊于新疆维吾尔自治区人民医院符合《国际疾病分类(第10版)》(ICD-10)诊断标准的92例难治性抑郁症患者,采用随机数字表法分为盐酸氟西汀组(对照组)和盐酸氟西汀联合利培酮组(观察组)各46例,疗程8周.于治疗前和治疗8周后,采用汉密尔顿抑郁量表17项版(HAMD-17)评定疗效,采用匹兹堡睡眠指数量表(PSQI)评定睡眠质量,采用自制不良反应记录表记录药物治疗过程中不良反应发生情况.结果 治疗8周后,观察组总有效率高于对照组(93.5% vs.78.3%,χ2=4.39,P<0.05),观察组HAMD-17评分低于对照组[(13.2±2.8)分 vs.(16.3±3.4)分,t=4.77,P<0.01],PSQI评分较对照组低[(10.2±1.2)分vs.(12.1±1.4)分,t=6.99,P<0.01].两组不良反应发生率比较差异无统计学意义(6.5% vs.13.0%,χ2=0.49,P=0.48).结论 单用盐酸氟西汀与盐酸氟西汀联合利培酮均可改善难治性抑郁症患者的临床症状及睡眠质量,但联合用药较单用盐酸氟西汀效果更好,二者安全性相当.
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