【摘要】 目的:评价认知行为疗法合并帕罗西汀治疗重度抑郁的疗效和安全性。方法:将符合国际疾病分类(ICD-10)重度抑郁发作诊断标准的66例患者随机分为两组,研究组(n=34)给予认知行为疗法合并帕罗西汀治疗,对照组(n=32)给予帕罗西汀治疗,疗程12周。于治疗前和治疗后2、4、6、8、12周采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体印象疗效总评量表病情严重程度(CGI-SI)、不良反应量表(TESS)评定疗效和不良反应。结果:治疗前研究组和对照组的HAMD、HAMA评分差异无统计学意义(t=-0.88,0.93;P>0.05)。治疗12周后,两组HAMD、HAMA评分均低于治疗前(研究组t=40.26,-27.29;P均<0.01;对照组t=19.11,70.85;P均<0.01);研究组6、8、12周HAMD、HAMA评分均低于对照组(t=-2.82,-2.84,-3.41;P均<0.05;t=-2.14,-3.01,-3.34;P均<0.05);研究组有效率高于对照组(χ2=4.799,P<0.05);研究组不良反应发生率低于对照组(χ2=4.855,P<0.05)。结论:认知行为疗法合并帕罗西汀治疗重度抑郁疗效较好,安全性高。更多还原

【Abstract】 Objective: To evaluate clinical efficacy and safety of cognitive- behavior therapy combined with paroxetine in the treatment of severe depression. Methods: 66 inpatients and outpatients who met ICD- 10 diagnostic criteria for severe depression were randomized to two groups. The research group( n = 34) received Cognitive- Behavior Therapy combined with paroxetine and the control group( n = 32)received paroxetine for 12 weeks. Clinical efficacy and adverse reaction were assessed with the Hamilton Depression Scale( HAMD),Hamilton Anxiety Scale( HAMA),Clinical Global Impression( CGI) and Treatment Emergent Symptom Scale( TESS) before treatment and at the end of the 2nd,4th,6th,8th,12 th week. Results: Before treatment,there were no significant differences in the scores of both HAMD and HAMA between the two groups. After 12 weeks treatment,the scores of HAMD and HAMA in both groups were lower than those before pretreatment( The research group t = 40. 26,-27. 29; P < 0. 01; the control group t = 19. 11,70. 85; P < 0. 01). At the end of the 6th,8th,12 th week,the scores of both HAMD and HAMA were lower in the research group than in the control group( t =-2. 82,-2. 84,-3. 41,-2. 14,-3. 01,-3. 34; P < 0. 05). The effective rate was higher in the research group than in the control group( χ2= 4. 799,P < 0. 05). The adverse reaction was lower in the research group than in the control group( χ2=4. 855,P < 0. 05). Conclusion: Cognitive- behavior therapy combined with paroxetine has a better efficacy and higher safety in the treatment of severe depression.更多还原