坦度螺酮对米那普仑治疗抑郁症的增效作用对照研究

徐丽莉　李春阳　刘俊贤　胡敏仪

【摘要】 目的：探讨坦度螺酮对米那普仑治疗抑郁症患者的增效作用，为临床优化治疗提供依据。方法：选取2017年11月-2018年6月本院60例抑郁症患者，按随机数字表法分为联用组与单用组，每组30例，联用组用坦度螺酮联合米那普仑治疗，单用组单用米那普仑治疗，两组均治疗8周。应用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）评定疗效，副反应量表（TESS）评定安全性和不良反应。结果：治疗前两组HAMD与HAMA评分比较，差异均无统计学意义（P>0.05）;治疗2、4、8周，联用组HAMD及HAMA评分均低于单用组（P<0.01）。联用组显效率高于单用组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：坦度螺酮联合米那普仑治疗抑郁症的效果好于单独应用米那普仑治疗。

【关键词】 抑郁症; 米那普仑; 坦度螺酮

Comparative Study on the Synergistic Effect of Tandospirone on the Treatmen of Depression with Milnacipran/XU Lili，LI Chunyang，LIU Junxian，et al.//Medical Innovation of China，2019，16（22）：0-041

【Abstract】 Objective：To investigate the synergistic effect of Tandospirone on the treatment of depression patients with Milnacipran，and to provide evidence for clinical optimal treatment.Method：60 patients with depression in our hospital from November 2017 to June 2018 were selected and divided into combined group and alone group according to the random number table method，30 cases in each group.The combined group was treated with Tandospirone combined with Milnacipran，the alone group was treated with Milnacipran alone，both groups were treated for 8 weeks.The efficacy was assessed by Hamilton depression scale（HAMD）and Hamilton anxiety scale（HAMA），the safety and adverse reactions were assessed by treatment emergent symptom scale（TESS）.Result：There were no significant differences in HAMD and HAMA scores between the two groups before treatment（P>0.05）.At the 2，4，8 week of treatment，HAMD and HAMA scores of the combined group were lower than those of the alone group（P<0.01）.The marked effective rate of the combined group was higher than that of the alone group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：The effect of Tandospirone combined with Milnacipran in the treatment of depression is better than that of Milnacipran alone.

【Key words】 Depression; Milnacipran; Tandospirone

First-authors address：Shunde Wuzhongpei Memorial Hospital of Foshan City in Guangdong Province，Foshan 528300，China

doi：10.3969/j.issn.1674-4985.2019.22.010

抑郁癥是一种常见的精神疾病，主要临床特征是思维迟缓、心境低落、意志活动减退等症状，严重的患者可出现自杀观念及行为。通常情况下，抑郁与焦虑是并存的，国内外相应研究发现60%～90%的抑郁症人群同时伴有焦虑症状[1]。抗抑郁药一般同时具有抗抑郁和抗焦虑的双重作用，被广泛用于抑郁症的治疗，但抗抑郁药不管是SSRIs类药物还是SNRI类药物，均存在起效慢、疗效不够理想的缺点[2]。国外文献报道，坦度螺酮作为一种新型抗焦虑药，近年来开始有研究表明，其可增强抑郁症患者抗抑郁药的效果[3]。国内已有文献报道坦度螺酮联合SSRI类抗抑郁药有提高抑郁症的疗效、缩短起效时间的优点[4-5]。本研究探讨应用坦度螺酮合用米那普仑治疗抑郁症的疗效和安全性，国内外文献报道较少，旨在为抑郁症的优化治疗提供更多选择，现报道如下。