【作者】 姜小琴； 杨开仁； 郑利锋； 周波； 杨志； 王梅； 郑芳；

【Author】 Jiang Xiaoqin;Yang Kairen;Zheng Lifeng;Zhou Bo;Yang Zhi;Wang Mei;Zheng Fang;The Third Hospital of Quzhou;

【机构】 衢州市第三医院精神科；

【摘要】 目的了解舍曲林合并无抽搐电休克治疗(MECT)对老年抑郁症患者的疗效与不良反应。方法对83例符合老年抑郁症的患者按随机数字表法分为研究组41例和对照组42例,研究组给予舍曲林合并MECT治疗,对照组单用舍曲林治疗,观察8周。分别于治疗前、治疗后第1、2、4和8周末时采用汉密尔顿抑郁量表(HAM D 17)评定疗效,不良反应症状量表(TESS)评定不良反应。研究组治疗前后采用临床记忆量表甲套评定认知功能。结果研究组脱落7例,对照组脱落5例。研究组治疗后第1、2、4、8周末时的HAM D 17总分较治疗前显著下降(P<0.05),对照组治疗第2、4、8周末HAM D 17总分较治疗前下降(P<0.05)。两组间治疗后第2周末时HAM D 17总分比较差异有统计学意义(P<0.05)。研究组治疗后第1个24h临床记忆量表甲套中指向记忆、图像自由回忆项目分较治疗前下降(均P<0.05),治疗第2周末联想学习、无意义图形再认项目分及记忆商值较治疗前升高(均P<0.05),治疗第8周末除图像自由回忆项目分外,其它项目分及记忆商值较治疗前升高(P<0.05或0.01)。研究组HAM D减分率(76.23±21.41)%,临床总有效率85.29%,临床痊愈率47.06%;对照组HAMD减分率(51.26±18.13)%,临床总有效率64.86%,临床痊愈率21.62%,两组间差异均有统计学意义(均P<0.05)。两组患者各时点的TESS评分比较差异无统计学意义(P>0.05)。结论抗抑郁药物合并M ECT治疗能提高老年抑郁症的疗效,无严重不良反应。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of modified electroconvul sivetherapy(MECT)combined with sertraline in treatment of elderly patients with major depression.Methods Eighty three elderly patients with major depression were randomly assigned toreceive MECT combined with sertraline(trial group,n=41)or sertraline(control group,n=42)for 8 weeks.The Hamilton Rating Seale for Depression(HAMD)and Treatment Emergent Symptom Scale(TESS)were used to measure therapeutic efficacy and side effects.The Clinical Memory Seale was used to evaluate cognitive functions priorto and post the treatment.Results HAMD score decreased 1 week after treatment intrial group,which was notsignificantly different to that of control group,while HAMD score intrial group was decreased more markedly thant hat of control group at the end of week 2.The directing memory and image free recollection of Clinical Memory Scale intrial group were deerease 24 h after treatment(P < 0.05),the scale scores and memory scores were increased significant lyat the end of weeks 8(P < 0.05 or P < 0.01).There were significant differences in the deereasing rate of HAMD score(76.23 ± 21.41%vs 51.26 ± 18.13%,P < 0.05),the response rate(85.29%vs64.86%,P < 0.05)and the recovery rate(47.06%vs21.62%,P < 0.05)between two groups.There was nosignificant difference in TESS scores between two groups(P > 0.05).Conclusion MECT combined with sertraline can improve efficacy for elderly patient swith major depression and notincr ease the side effects.更多还原