舒必利联合西酞普兰治疗伴精神病性症状抑郁症的临床效果研究

目的:研究舒必利联合西酞普兰治疗伴精神病性症状抑郁症的临床效果。方法:将某院2013年6月~2015年6月收治的伴精神病性症状抑郁症患者76例,随机分为两组各38例,观察组采用舒必利联合西酞普兰进行治疗,对照组采用西酞普兰治疗,比较两组治疗前后HAMD、HAMA评分变化和疗效。结果:观察组治疗后HAMD、HAMA评分均低于对照组,差异均具有统计学意义(均P0.05);观察组总有效率高于对照组,差异具有统计学意义(P0.05)。结论:舒必利联合西酞普兰治疗伴精神病性症状抑郁症效果较单纯西酞普兰治疗更好,值得临床上推广。     

鼻内窥镜治疗鼻窦炎伴鼻息肉的临床效果评价

目的观察鼻窦炎伴鼻息肉患者采取鼻内窥镜治疗的效果。方法 120例鼻窦炎伴鼻息肉患者,随机分为对照组及研究组,各60例。对照组采用鼻腔开放手术治疗,研究组实施鼻内窥镜治疗。比较两组患者的治疗效果、症状消失时间及住院时间。结果对照组中,无效9例、有效15例、显效36例,总有效率为85.00%;研究组中,无效2例、有效17例、显效41例,总有效率为96.67%。研究组总有效率高于对照组,差异具有统计学意义(χ2=4.904, P<0.05)。对照组患者的症状消失时间及住院时间分别为(6.32±0.49)、(8.76±0.29)d,研究组患者的症状消失时间及住院时间分别为(3.13±0.38)、(5.68±0.63)d。研究组患者的症状消失时间及住院时间均短于对照组,差异均具有统计学意义(P<0.05)。结论鼻内窥镜在鼻窦炎伴鼻息肉疾病治疗中效果明显,不仅可以使患者临床病症减轻,同时有助于患者短时间内恢复健康。     

氟哌噻吨美利曲辛对冠心病患者焦虑抑郁症的改善作用研究

目的探究氟哌噻吨美利曲辛在冠心病患者伴焦虑抑郁症治疗中的临床应用价值。方法本文采用回顾性研究,在本院共收集100例冠心病伴焦虑、抑郁症的患者,随机分为研究组和对照组,分别采用氟哌噻吨美利曲辛治疗和常规治疗,比较两组患者的情况。结果治疗后两组患者的SDS评分及SAS评分明显下降,与治疗前的差异存在统计学意义(P<0.05);治疗后的研究组评分下降比对照组更明显,差异存在统计学意义(P<0.05)。研究组和对照组有效率分别为96%、80%,差异有统计学意义(χ2=7.68,P<0.05)。结论氟哌噻吨美利曲辛可有效改善患者的焦虑、抑郁症状,同时可缓解冠心病患者的临床症状,值得在临床上推广应用。     

加味解郁舒胃汤治疗功能性消化不良伴抑郁症的临床疗效观察

目的探讨加味解郁舒胃汤治疗功能性消化不良(FD)伴抑郁症的临床效果。方法将符合诊断标准的137例FD伴抑郁症的患者分为两组,观察组84例采用加味解郁舒胃汤治疗,对照组53例采用吗丁啉(多潘立酮)、谷维素,帕罗西汀等西药治疗。治疗8周后比较两组患者的消化道症状和Zung抑郁自评量表(SDS)症状评分改善情况及不良反应发生情况。结果观察组FD总有效率为90.5%(76/84),对照组FD总有效率为75.5%(40/53),两组比较,差异有统计学意义(P<0.05);两组SDS症状评分较治疗前均明显降低(P<0.01),而且观察组SDS症状评分较对照组降低更显著(P<0.01)。两组均未出现严重不良反应。结论加味解郁舒胃汤治疗FD伴抑郁症的临床效果显著,无严重不良反应,值得临床推广应用。     

干预措施对精神分裂症急性期伴自杀行为的疗效分析

目的探讨干预措施对预防急性期伴自杀行为精神分裂症患者的疗效。方法对70例精神分裂症急性期伴自杀行为患者随机分成两组,一组35例进行干预治疗(研究组),另一组35例没有进行任何干预(对照组),对两者有关资料进行比较分析。结果经过干预后研究组在第2周、第4周和第8周时自杀发生率明显减少,与对照组比较,存在显著统计学差异(P<0.05);研究组在第2周时PANSS总分、BPRS总分、焦虑抑郁和敌对猜疑明显好于对照组;在第四周时PANSS总分、BPRS总分、阳性症状、一般精神病理、焦虑抑郁、思维障碍和敌对猜疑明显优于对照组(P<0.05)。结论正确的干预措施能够降低急性期精神分裂症患者自杀行为的发生率,尤其对病情及精神病性症状、焦虑抑郁、思维障碍和敌对猜疑的治疗可有效减少自杀行为的发生。     

奥氮平联合利培酮治疗伴激越症状的精神分裂症的临床观察

目的 研究奥氮平+利培酮运用于伴激越症状的精神分裂症中的价值。方法 选取我院收治的伴激越症状的精神分裂症患者70例，随机分为研究组和对照组，各35例。研究组采取奥氮平+利培酮，对照组服用奥氮平，对比两组的总有效率、阳性和阴性症状量表(PANSS)、兴奋量表(PANSS-EC)、不良反应，比较两组用药结果。结果 研究组总有效率高于对照组(P<0.05)。服药前各组的PANSS评分并差别(P>0.05),服药后研究组阳性症状、阴性症状、一般精神病性评分、、总分均低于对照组(P<0.05)。服药前各组的PANSS-EC评分并差别(P>0.05),服药后3d、1周、2周研究组评分均低于对照组(P<0.05)。研究组不良反应发生率少于对照组(P<0.05)。结论 奥氮平+利培酮的疗效更为理想，能够促进患者症状减轻，尤其是激越症状，从而稳定病情，值得推广。     

抑郁症伴睡眠障碍患者应用米氮平联合西酞普兰治疗的临床价值分析

目的探究西酞普兰与米氮平联合治疗抑郁症伴睡眠障碍患者的临床疗效。方法此次实验对象全部选自大连第七人民医院2015年4月至2018年6月期间收治的200例抑郁症伴睡眠障碍患者,均分成研究组(n=100)和对照组(n=100),对照组单用西酞普兰,在此基础上研究组联合米氮平治疗,将两种治疗结果分析比较。结果研究组和对照组患者在治疗后的MADRS评分、HAMD-17评分、PSQI评分以及治疗总有效率差异上,有统计学意义(P <0.05);在不良反应发生率差异上,未有统计学意义(P> 0.05)。结论西酞普兰与米氮平联合治疗抑郁症伴睡眠障碍患者的临床效果较好,可缓解患者抑郁和失眠症状,且药物安全性较高。     

米氮平治疗抑郁症伴躯体障碍患者95例的疗效观察

目的探讨米氮平、阿米替林治疗抑郁症伴有躯体化障碍的疗效、安全性和依从性。方法将95例抑郁症伴躯体化症状的患者随机分为两组,分别给予米氮平(研究组,n=48)和阿米替林(对照组,n=47)治疗4周。采用汉米尔顿抑郁量表(HAMD)和汉米尔顿焦虑量表(HAMA),SCL-90躯体化因子评分比较判断疗效,临床总体印象量表(CGI-SI)评定病情严重程度。治疗中出现的症状量表(TESS)评定不良反映。结果治疗后两组患者HAMD、HAMA、SCL-90躯体化因子评分显著下降(P<0.01),组间差异无显著性,研究组在2、4、6周末均有下降,而对照组在4、6周末下降明显,研究组不良反映发生率明显低于对照组(P<0.05)。结论米氮平有明显改善患者躯体化不适,失眠、厌食、尿频、性欲下降等症状,副反应少,对患者的耐受性、依从性好。     

疏肝解郁安神汤治疗失眠伴抑郁症患者的临床效果观察

目的 研究疏肝解郁安神汤治疗失眠伴抑郁症患者的临床效果.方法 80例失眠伴抑郁症患者作为研究对象,随机分为研究组与对照组,每组40例.对照组患者采用常规西药治疗,研究组患者采用疏肝解郁安神汤治疗.比较两组患者治疗前后汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)评分及治疗效果.结果 治疗前,两组患者HAM...     

胃溃疡伴抑郁症采用氟哌噻吨美利曲辛治疗的临床价值分析

目的分析探讨胃溃疡伴抑郁症行氟哌噻吨美利曲辛治疗的临床效果。方法选取我院近年来收治的94例胃溃疡伴抑郁症患者作为研究对象,按照患者治疗方法将其分为研究组与对照组,每组47例,研究组在常规治疗的基础上行氟哌噻吨美利曲辛治疗,对照组患者行常规治疗,比较两组患者病症改善效果。结果研究组治疗总有效率为95.8%,治愈率为51.1%,对照组患者治疗总有效率为80.9%,治愈率为29.8%,组间比较差异有统计学意义(P<0.05);研究组患者抑郁状况改善效果明显优于对照组(P<0.05);两组治疗期间不良反应发生率无显著差异(P>0.05)。结论对胃溃疡伴抑郁症患者行氟哌噻吨美利曲辛治疗能够改善患者溃疡病症,缓解患者的抑郁症状,应用效果十分显著,可以进行推广应用。     

抑郁症患者客观睡眠与临床特征的相关性

目的 分析抑郁症患者的客观睡眠,探讨患者睡眠状况与抑郁症状的关系.方法 34例抑郁症患者为抑郁症组,21例健康者为健康对照组,两组均进行多导睡眠监测(polysomnography,PSG).采用汉密尔顿抑郁量表(HAMD-24)对抑郁症组临床症状进行评估.结果 (1)与健康对照组相比,抑郁症组总睡眠时间(TST)减少[(463.90±45.76) min比(426.57±83.85) min(P ＜0.05)],睡眠潜伏期(SL)延长[(20.47 ±5.94) min比(46.49±55.42) min(P ＜0.01)]、快眼动睡眠(REM)减少[(81.91 ±29.05) min比(55.66±39.76) min(P＜0.05)]及快眼动睡眠比例(REM％)[(17.28±6.00)％比(12.91±8.65)％(P＜0.05)]降低.(2) Pearson相关分析显示,抑郁症组的HAMD-24得分与N3(r=-0.353,P＜0.05)存在负相关.结论 抑郁症患者的睡眠状况较正常存在明显变化;抑郁症患者抑郁程度越重,深睡眠时间就越少,睡眠紊乱状况也越重.     

严重颜面部烧伤的近期并发症及生存质量间的相关因素分析

目的：分析严重颜面部烧伤的近期并发症及生存质量间的相关因素。方法回顾性研究2008年3月—2014年3月收治的237例面部烧伤患者的临床资料。应用患者和观察员瘢痕评估量表（POSAS）,罗森堡自尊量表和医院焦虑抑郁量表,结构方程模型评估抑郁症状,自尊和瘢痕的严重程度之间的关系。结果 T1期自尊与T1期面部瘢痕、T2期抑郁症状无显著相关性。与此相反,T1期面部瘢痕与T 0期抑郁症之间存在显著关联（P ＜0．001）。抑郁症状和自尊之间的相关性有统计学意义。早期的抑郁症状和自尊的显著关系表明,抑郁症病史或烧伤3周后（ T 0）罹患严重抑郁症状的患者,T1期自尊评分偏低（P＜0．001）。结论自尊和抑郁症与面部瘢痕严重程度无相关性。但早期抑郁症状可以对面部瘢痕进行评级。     

肺表面活性物质治疗新生儿呼吸窘迫综合征30例疗效分析

目的 探讨肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效.方法 观察组30例NRDS患儿给予气管内滴注单剂PS治疗,对照组22例未给予PS治疗,其余治疗两组相同.结果 观察组早期应用PS后,患儿临床症状明显改善,动脉血氧分压(PaO2)和动脉/肺泡血氧分压比值(a/APO2)明显上升,氧合指数(OI)值明显下降,改善程度好于对照组(P＜0.01).床旁胸部X线片显示,与对照组比较,观察组改善更快,效果更好(P＜0.01),对机械通气和氧疗的需求显著降低(P＜0.05).结论 PS对NRDS疗效满意,能提高患儿的生存质量,值得推广.     

The relationship between depression and the dexamethasone suppression test following alcohol withdrawal in a psychiatric population

The authors administered at least one dexamethasone suppression test (DST) and Hamilton Rating Scale for Depression (HRSD) simultaneously to 30 psychiatric inpatients following detoxification from alcohol. Twenty-five of these were also interviewed using the NIMH Diagnostic Interview Schedule (DIS). Fifteen patients had two or three sequential DSTs at weekly intervals. Seven of the patients were clinically diagnosed as having a major depressive episode based on close observation over 2 to 4 inpatient weeks free of psychotropic medications. Fifty-eight percent of the initial cortisol determinations with the first 2 weeks showed nonsuppression, as did 60% after 2 weeks. While the level of depressive symptoms was initially high (HRSD score greater than 20) for 48% of the 27 patients interviewed within 2 weeks of abstinence, depressive symptoms cleared within 2 weeks in half of these cases. There were no associations between DST results and the presence of DSM-III major depressive disorder (lifetime or current) as assessed by the NIMH DIS, scores on the HRSD, or the presence of liver disease (elevated admission SGOT or SGPT). By the 15th-day of abstinence an examination of the clinical course of depressive symptoms differentiated those patients with a persistent major depressive episode from those with transient, alcohol-related depressive symptoms. An early positive DST had a positive predictive value of 20% for a clinical diagnosis of a major depressive episode, and a negative predictive value of 73%. After 2 weeks the positive and negative predictive values were each 50%.     

Genetic determinants of circulating VEGF levels in major depressive disorder and electroconvulsive therapy response

Alterations in peripheral vascular endothelial growth factor (VEGF) levels were observed in major depressive disorder and relative treatments and were shown to be influenced by genetic variants. The study objective was to explore, at a genome-wide level, possible interplaying effects between the genetic background and major depressive disorder in regulating VEGF levels. Moreover, we aimed to investigate the association between these variants and response to electroconvulsive therapy. A genome-wide association study was carried out both on controls and patients with major depressive disorder (n = 145; n = 121) in correlation with serum VEGF levels determined by ELISA. Five SNPs not included in SNP arrays were additionally genotyped. Seventy-one patients with treatment-resistant depression underwent electroconvulsive therapy and were evaluated as responders/nonresponders. An association between VEGF levels and a locus in 6p21.1, downstream the VEGF gene, was evidenced both in controls (best SNP: FDR-corrected p = 2.4 × 10⁻⁵) and in patients with major depressive disorder (best SNP: FDR-corrected p = 2.6 × 10^–3). The alleles associated with lower VEGF concentrations in patients were also associated with nonresponse to electroconvulsive therapy (p = .01). These results confirm a role of SNPs in 6p21.1 locus as major influencers of circulating VEGF levels also in patients affected by major depressive disorder and indicate a possible implication in response to electroconvulsive therapy.     

普萘洛尔三联小剂量对肝硬化门脉高压症近期疗效临床研究

目的:探讨普萘洛尔三联小剂量疗法对肝硬化门脉高压症(PHT)的近期疗效及其作用机制。方法:对68例肝硬化门脉高压症患者随机分为2组:34例三联治疗组和34例二联治疗组。三联治疗组采用口服普萘洛尔(propranolol)10mg,每日3次,螺内酯40mg,每日2次,新亚丹肖(5-单硝酸异山梨酯)20mg,每日2次(PIS方案)。二联治疗组患者采用口服普萘洛尔10mg,每日3次,螺内酯40mg,每日2次(PS方案)。两组疗程均为半年以上。用彩色多普勒超声仪(CDFI)检测两组治疗前、后门静脉系统血流动力学的变化。结果:用药1周后两组门静脉血流量(Qpv)、脾静脉血流量(Qsv)、门静脉血流速度(Vpv)和脾静血流速度(Vsv)均显著下降(P均<0.01);用药4周后Qpv、Qsv、门静脉内径(Dpv)、脾静脉内径(Dsv)均显著下降,与用药前比较差异有显著性(P均<0.01);经3个月的随访,临床上未见明显不良反应。PIS方案组PHT显著低于PS方案组,PHT出血率PIS方案组20.6%(7/34),显著低于PS方案组44.1%(15/34)(P<0.05)。病死率PS方案组为32.4%(11/34),PIS方案组为11.8%(4/34),PS方案组显著高于PIS方案组(P<0.05)。两组中ChildC级患者的再出血率和病死率差异无显著性(P>0.05)。用药12周后PIS方案组Qpv、Qsv、MAP显著低于PS方案组(P均<0.05)、HR显著高于PS组(P均<0.01)。结论:PIS     

Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial

Rationale

Saffron (Crocus sativus L.) has shown aphrodisiac effects in some animal and human studies.

Objectives

To assess the efficacy and tolerability of saffron in fluoxetine-related sexual dysfunction.

Methods

This was a 4-week randomized double-blind placebo-controlled study. Thirty-six married male patients with major depressive disorder whose depressive symptoms had been stabilized on fluoxetine and had subjective complaints of sexual impairment entered the study. The patients were randomly assigned to saffron (15?mg twice per day) or placebo for 4?weeks. International Index of Erectile Function scale was used to assess sexual function at baseline and weeks 2 and 4.

Results

Thirty patients finished the study. Baseline characteristics as well as baseline and final depressive symptoms scores were similar between the two groups. Effect of time?×?treatment interaction on the total score was significant [Greenhouse–Geisser-corrected, F (1.444, 40.434)?=?6.154, P?=?0.009]. By week 4, saffron resulted in significantly greater improvement in erectile function (P?P?=?0.001), and total scores (P?P?=?0.095), overall satisfaction (P?=?0.334), and sexual desire (P?=?0.517) domains scores. Nine patients (60%) in the saffron group and one patient (7%) in the placebo group achieved normal erectile function (score?>?25 on erectile function domain) at the end of the study (P value of Fisher’s exact test?=?0.005). Frequency of side effects were similar between the two groups.

Conclusions

Saffron is a tolerable and efficacious treatment for fluoxetine-related erectile dysfunction.     

Long-term functioning and sleep quality in patients with major depressive disorder treated with extended-release quetiapine fumarate

The aim of this study was to assess patients' functioning and sleep quality during extended-release quetiapine fumarate (quetiapine XR) maintenance treatment. A double-blind, randomized-withdrawal maintenance study of quetiapine XR monotherapy was carried out in patients with major depressive disorder. Following 4-8 weeks of open-label quetiapine XR and 12-18 weeks of open-label quetiapine XR stabilization (50, 150, or 300 mg/day), eligible patients were randomized to quetiapine XR (50, 150, or 300 mg/day) or placebo. Secondary variables of the Sheehan Disability Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) were used to assess functioning and sleep quality and are reported here. Quetiapine XR significantly maintained functioning versus placebo. Changes in the least squares means (LSM) from randomization in the SDS total scores were as follows: -0.45, quetiapine XR (P<0.05), versus 0.44, placebo. Quetiapine XR significantly maintained SDS domains 'social life/leisure' (-0.19; P<0.05) and 'family life/home responsibilities' (-0.22; P<0.05) versus placebo (0.13 and 0.10, respectively). Quetiapine XR significantly maintained sleep quality (LSM change in PSQI total scores: 0.06, quetiapine XR vs. 1.35, placebo; P<0.001), with five of seven PSQI components being significant for quetiapine XR versus placebo. In conclusion, quetiapine XR (50-300 mg/day) monotherapy better maintains overall functioning and sleep quality than placebo in patients with major depressive disorder.     

肺表面活性物质预防早产儿呼吸窘迫综合征的疗效观察

目的:探讨早产儿生后6 h内使用牛肺表面活性剂(PS)预防新生儿呼吸窘迫综合征(NRDS)的疗效。方法:我院出生的76例胎龄28～32周的早产儿随机分为两组,预防组38例给予气管内注入40～100 mg/kg牛肺表面活性剂与未用PS的对照组38例进行前瞻性临床研究,比较两组NRDS的发生情况。结果:预防组发生NRDS 5例,对照组发生NRDS 17例,两组比较差异有统计学意义(P<0.05)。预防组吸氧天数(9.2±6.1)d、呼吸机使用天数(6.5±4.9)d及住院天数(29.3±7.8)d,较对照组(16.7±6.4)d、(9.8±7.0)d、(37.4±7.2)d明显缩短,差异有统计学意义(P<0.05)。预防组肺部并发症如肺部感染及支气管肺发育不良较对照组明显减少,两组比较差异有统计学意义(P<0.05)。结论:早产儿预防性使用牛肺表面活性剂能减少NRDS的发生率,减少呼吸机的使用,减少肺部并发症发生,改善早产儿预后。     

Hypoalbuminemia in drug-free patients with major depressive disorder compared with a dietary matched control group: a clinical meaning beyond malnutrition.

Serum albumin (sALB) is routinely determined in blood tests and is an excellent predictor of risk for many medical illnesses. Hypoalbuminemia has been sporadically reported in patients with psychiatric disorders, such as major depressive disorder and schizophrenia. We compared sALB levels between 19 drug-free patients of major depressive disorder with a control group of matching diets. We conducted this study by controlling the nutrition factor by assessing patient's diets, as well as other possible confounding factors such as sex, age, body mass index (BMI), liver function, and exercise, while focusing on hypoalbuminemia in patients with major depressive disorder. There is no difference in age, gender distribution, and dietary frequency on protein and albumin intake between the patient and control group. The sALB levels of the group with major depressive disorder were significantly reduced (p=0.049). The severity of depression is negatively correlated to the sALB level (r=-0.46, p=0.04). Hypoalbuminemia has clinical meanings on severity of depression and is independent of malnutrition. However, our results can only be seen as very preliminary and should be confirmed by larger studies.