文拉法辛联合低剂量氨磺必利治疗重度抑郁症的疗效观察

摘要

Objective To investigate the effect and safety of venlafaxine augmented with amisulpride in the treatment of major depressive disorder. Methods Fifty patients with major depressive disorder were randomly divided into control group treated with venlafaxine (n=25) and study group treated by venlafaxine augmented with amisulpride (n=25). The treatment lasted 8 weeks. Hamilton Depression Rating Scale (HAMD) and Treatment Emergent Symptom Scale (TESS) were used to evaluate the effect and safety of therapy before and 1, 2, 4, and 8-week after treatment. The serum level of IL-18 was detected at each time points in two groups. Results After treatment for 2, 4 and 8 weeks, the serum levels of IL-18 were significantly decreased in study group than that of control group (P<0.05). The serum levels of IL-18 were gradually reduced with the extended treatment time in two groups. There was no interaction between two groups and different processing times. Scores of HAMD decreased gradually after treatment in two groups. Scores of HAMD were significantly lower after treatment than that before treatment in study group (P<0.05). Scores of HAMD were significantly lower after treatment than that before treatment except for one-week treatment in control group (P<0.05). There were no significant differences in HAMD scores before treatment and one-week treatment of two groups. Scores of HAMD were significantly lower 2,4 and 8 weeks after treatment in study group compared with those of control group (P<0.05). There was a interaction between groups and processing times (P<0.05). The effective rates increased in study group (96%) than control group (76.0%). The adverse effects were less in two groups. Conclusion The low dose of amisulpride helps to improve the efficacy of venlafaxine in the treatment of major depressive disorder, which has good security and can inhibit inflammatory reaction.%目的：探讨文拉法辛联合低剂量氨磺必利治疗重度抑郁症的临床效果及安全性。方法采用随机数字表法将50例重度抑郁症患者分成对照组和研究组，每组25例，分别给予文拉法辛和文拉法辛联合低剂量氨磺必利治疗，疗程均为8周，分别在治疗前和治疗1、2、4、8周末采用汉密尔顿抑郁量表（HAMD）及副反应量表（TESS）评定疗效及不良反应。检测各个治疗时间段患者血清炎性因子白细胞介素（IL）-18水平。结果治疗2、4、8周后研究组IL-18水平较对照组均明显降低，差异有统计学意义（P＜0.05）；2组IL-18水平均随着治疗时间的延长逐渐降低；分组与处理时间之间不存在交互作用。2组HAMD评分在治疗后均逐渐下降。研究组治疗后各时间点HAMD评分均低于治疗前（P＜0.05）；对照组除治疗后1周外，其余各治疗时间点均低于治疗前（P＜0.05）。组间比较，治疗前和治疗1周时2组HAMD评分差异无统计学意义，治疗2、4、8周后研究组HAMD评分均低于对照组（P＜0.05）。分组与处理时间之间存在交互作用（P＜0.05）。治疗8周后研究组总有效率（96.0%）高于对照组（76.0%）。2组不良反应均较少。结论文拉法辛联合低剂量氨磺必利有助于提高治疗重度抑郁症的疗效，安全性好，可减轻炎症反应。