A Controlled Study on Treatment of Mental Depression by Acupuncture plus TCM Medication

Objective: To evaluate the therapeutic effect and safety of acupuncture plus TCM medication for treatment of mental depression. Method: 61 cases of mental depression were randomly divided into a treatment group of 30 cases and a control group of 31 cases. The former group was treated by acupuncture plus TCM medication, and the latter with TCM medication alone. The Hamilton Mental Depression (HAMD) scoring system was adopted to evaluate the therapeutic effects, and the Treatment Emergent Symptom Scale (TESS) was used to evaluate the adverse reactions. Results: The treatment group was superior to the control group in the total effective effect (P<0.05), with a significant difference in the HAMD score before and after treatment between the 2 groups (P<0.01). There were marked differences in the reducing rate of HAMD score at the end of the second and sixth week of the treatment between the 2 groups (P<0.05) and the difference was very obvious at the end of the fourth week (P<0.01). No remarkable difference was found in adverse reactions between the 2 groups (P>0.05). Conclusion: Acupuncture plus TCM medication may show satisfactory results for mental depression, indicating that a synergic action may exist between acupuncture and TCM medication.     

Combination therapy with pegylated interferon alpha-2b and adefovir dipivoxil in HBeAg-positive chronic hepatitis B versus interferon alone: a prospective,randomized study

Currently available monotherapies of oral nucleoside/nucleotide analogs or interferon are unable to achieve a sustained and effective response in most of patients with chronic hepatitis B（CHB）. The objective of the present study was to compare the efficacy and safety of pegylated interferon（Peg-IFN） alpha-2b plus adefovir dipivoxil combination therapy versus Peg-IFN alpha-2b alone. Sixty-one HBeAg-positive chronic hepatitis B patients were randomized to receive Peg-IFN alpha-2b alone（1.5 μg/kg once weekly） or Peg-IFN alpha-2b plus adefovir（10 mg daily） for up to 52 weeks. Efficacy and safety analyses were performed on all participants who received at least one dose of study medication. The rate of HBeAg seroconversion and undetectable HBV-DNA were evaluated after 52 weeks of therapy. At the end of treatment, 11 of 30（36.7%） patients receiving combination therapy achieved HBeAg seroconversion versus 8 of 31（25.8%） in the monotherapy group（P=0.36）. In contrast, the percentage of patients with undetectable serum HBV DNA was significantly higher in the combination group than in the monotherapy group（76.7% vs. 29.0%, P〈0.001）. Thyroid dysfunction was more frequent in the combination group than in the monotherapy group（P〈0.05）. In HBeAg-positive CHB, combination of Peg-IFN alpha-2b and adefovir for 52 weeks resulted, at the end of treatment, in a higher virological response but without significant impact on the rate of HBeAg seroconversion and possibly an adverse effect on thyroid function.     

Treatment of patients with severe sepsis using Ulinastatin and Thymosin α1: a prospective, randomized, controlled pilot study

Background Tradition treatment of sepsis and new therapies, including high dose corticosteroids and non-steroidal anti-inflammatory drugs, have proven unsuccessful in improving survival. This study aimed to evaluate the potential efficacy of immunomodulating therapy using Ulinastatin （UTI） plus Thymosin al （Tal） for improving organ function and reducing mortality in patients with severe sepsis. Methods A prospective study was carried out with randomized and controlled clinical analysis of 114 patients conforming to the enrollment standard. All patients had severe sepsis and received standard supportive care and antimicrobial therapy. Fifty-nine patients were also administered UTI plus Tal （defined as Group A）, 55 patients were given a placebo （defined as Group B）. Clinical parameters were determined by evaluation with the Acute Physiology and Chronic Health Evaluation II （APACHE II）, multiple organ failure （MOF） and the Glasgow Coma Scores （GCS） on entry and after therapy on the 3rd, 8th, and 28th day. By flow cytometery and ELISA lymphocyte subsets and cytokines were analyzed. Survival analysis was determined by the Kaplan-Meier method at 28, 60, and 90 days. Results Based on comparison of the two groups, patients in Group A exhibited a better performance in organ failure scores which was noticeable soon after initiation of treatment. Patients in Group A also demonstrated a better resolution of pre-existing organ failures during the observation period. After initiation of treatment, significant improvements in the CD4^＋/CD8^＋ ratio, a quicker balance between proinflammatory mediators such as tumor necrosis factor a, interleukin 6 and anti-inflammatory cytokines including interleukin 4 and interleukin 10 were found. This was followed by cumulative survival increases of 17.3% at 28 days, 28.9% at 60 days, and 31.4% at 90 days in Group A. The reduction in mortality was accompanied by a considerably shorter stay in the ICU and a shorter length of supportive ventilation, antimicrobial and dopamine therapy. Conclusion UTI plus Tal has a beneficial role in the treatment of severe sepsis.     

Clinical observation on treatment of depression by electro-acupuncture combined with Paroxetine

Objective:To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.Methods:Forty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine,and the control group (20 patients) treated with Paroxetine alone,and the therapeutic course for both groups was 6 weeks.The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.Results:HAMD scores determined at the end of the 1st,2nd,4th,and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05).The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%).No significant difference of TESS scores was found between the two groups.Conclusion:EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone,with milder adverse reaction and quicker initiation of effect.     

Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training

To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia,a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups:conventional swallowing therapy group,VitalStim therapy group,and VitalStim therapy plus conventional swallowing therapy group.Prior to and after the treatment,signals of surface electromyography(sEMG) of swallowing muscles were detected,swallowing function was evaluated by using the Standardized Swallowing Assessment(SSA) and Videofluoroscopic Swallowing Study(VFSS) tests,and swallowing-related quality of life(SWAL-QOL) was evaluated using the SWAL-QOL questionnaire.There were significant differences in sEMG value,SSA,VFSS,and SWAL-QOL scores in each group between prior to and after treatment.After 4-week treatment,sEMG value,SSA,VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group,but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group.It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.     

Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors

Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem.Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.Methods In this prospective,multicenter,open-label,randomized controlled trial,77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole.The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.Results Seven days after the end of therapy a clinical cure was achieved for 76.7％ （23 of 37） of efficacy-evaluable patients in the moxifloxacin group and 51.7％ （15 of 40） of patients in the levofloxacin plus metronidazole group.There was a significant difference between the two groups （x2=4.002,P ＜0.05）.Bacteriological success rates were similar in the moxifloxacin group （93.3％） and levofloxacin plus metronidazole group （96.4％）,there was no significant difference between the two groups （P ＞0.05）.The overall adverse event rate was 10.8％ （4/37） in the moxifloxacin group versus 17.5％ （7/40） in the levofloxacin plus metronidazole group,there was no significant difference between the two groups （P＞0.05）.No serious adverse events were observed.Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors.And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.     

Thirty Cases of Obsession Treated by Point-Stimulation and with Small Dose of Chlorimipramine

Objective: To investigate the clinical therapeutic effects of point-stimulation for obsession. Methods: Sixty cases of obsession were divided into two groups: a control group of 30 cases treated with chlorimipramine (Ch1), and a treatment group of 30 cases treated by point-stimulation (PS) plus chlorimipramine (PS Chl). The therapeutic effects and side-effect were evaluated according to the criteria set in Yale-Brown Obsession Scale (Y-BOCS), Hamilton's depression scale (HAMD), brief psychiatric rating scale (BPRS) and treatment emergent symptom scale (TESS). Results: The cure rate and markedly effective rate were respectively 26.7% and 56.6% in the control group, and 43.3% and 50% in the treatment group, suggesting that the therapeutic effect in the treatment group was better than that in the control group. The incidence of adverse side-effects was 73.33% in the control group and 46.67% in the treatment group, with a significant difference between the two groups (P<0.05). Conclusion: Point-stimulation plus small dose of chlorimipramine was superior to the simple chlorimipramine treatment, indicating that the combined method was more effective and safe for obsession with less side effects.     

Comparison of emergency endoscopic variceal ligation plus octride or octride alone for acute esophageal variceal bleeding

Background Octride was the main method for the treatment of esophageal variceal bleeding （EVB）. The aim of this study was to compare the cost-effect and safety between esophageal variceal ligation （EVL） plus octride and octride alone in acute esophageal bleeding. Methods A total of 101 cirrhotic patients with EVB were involved in this study and received emergency EVL ± octride （EVL group） or only octride therapy randomly. The cost, efficacy and safety were analyzed and compared between the two groups. Results Among 51 patients in EVL group, 5 （10%） patients failed. Among 50 patients in the octride treatment group, 13 patients （26%） failed. The difference was significant （P 〈0.05）. The average blood transfusion volume was （2.4±2.2） units in the EVL group and （6.4±3.4） units in the octride treatment group （P〈0.05）. Hospital stay was （7.4±1.3） days in the EVL group and （11.4±3.3） days in the octride treatment group （P 〈0.05）. The average hospital cost was （10 983±1147） yuan in the EVL group and （13 921 ±2107） yuan in the octride treatment group （P 〈0.05）. Conclusion Emergency endoscopic ligation plus octride is superior to octride alone in the treatment of acute EVB with lower cost and higher efficacy with enough safety.     

Effectiveness of Bushen Huoxue Granule (补肾活血颗粒) on 5-Serotonin and Norepinephrine in the Brain of Parkinson''s Disease Patients with Depressive State

Objective：To observe the clinical curative effect of Chinese medicine Bushen Huoxue Granule（补肾活血颗粒,BHG） on Parkinson＇s disease（PD） patients with depressive state.Methods：Sixty-two PD patients with depressive state were randomly assigned to two groups by using a random number table,31 in each group.Madopar was given to all as the conventional treatment.The fluoxetine hydrochloride dispersible tablet was given to the patients in the control group and BHG was given to those in the treatment group.The therapeutic course for all was 12 weeks.Before and after treatment,Hamilton depression rating scale（HAMD） was applied to judge the curative effect,and the changes of cerebral neurotransmitters levels in the brain of patients were detected by encephalofluctuograph technique.Results：The scores of HAMD in the two groups were decreased markedly after 12-week treatment.It was lower in the treatment group than that in the control group with significant difference（P〈0.01）.The contents of norepinephrine（NE） and 5-serotonin（5-HT） in the PD patients were obviously lower than normal value.There was no significant difference between the two groups before treatment（P〉0.05）.The contents of NE and 5-HT were all increased in the two groups after treatment（P〈0.05）,with significant differences between the two groups（P〈0.01）.Conclusion：BHG could increase the contents of NE and 5-HT in PD patients＇ brain to improve the depressive state of PD patients.     

A Multi-center,Randomized,Controlled and Open Clinical Trial of Heyan Kuntai Capsule (和颜坤泰胶囊) and Hormone Therapy in Perimenopausal Women

Objective: To evaluate the efficacy and safety of Heyan Kuntai Capsule(和颜坤泰胶囊, HYKT) and hormone therapy(HT) on perimenopausal syndromes(PMSs). Methods: From 2005 to 2008, 390 women with PMSs were recruited from 4 clinic centers. The inclusion criteria included ages 40 to 60 years, estradiol(E2) below 30 ng/L, and follicle stimulating hormone(FSH) above 40 IU/L, etc. The patients were randomly assigned to HYKT group or HT group by random number table method, administrated HYKT or conjugated estrogen with/without medroxyprogesterone acetate tablets for 12 months. During treatment, the patients were interviewed quarterly, Kupperman Menopausal Index(KMI) scores, hot flush scores, insomnia scores, Menopause-Specific Quality of Life(MENQOL) scores and adverse effects were used for evaluating drug efficacy and safety respectively. The last interview was made at the end of 12-month treatment. Results: After treatment, KMI scores of HYKT group and HT group were both significantly decreased compared with baseline(P0.01) and there was no significant difference between groups(P0.05), except that KMI of HYKT group was higher after 3-month treatment(P0.05). After treatment, hot flush and insomnia scores were both improved significantly in two groups(P0.01); and HT had a better performance than HYKT in improving hot flush(P0.05). MENQOL were significantly improved in both groups after treatment(P0.01); but there was no significant difference between two groups(P0.05). The incidence of adverse event in the HYKT group was much lower than that in the HT group(P0.01). Conclusions: HYKT could effectively relieve PMSs and improve patient quality of life without severe adverse reactions. Although HYKT exerted curative effects more slowly than hormone, it possessed better safety profile than hormone.     

Menopausal depression:comparison of hormone replacement therapy and hormone replacement therapy plus fiuoxetine

Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with ]4 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combination with HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy. Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events. Conclusion HRT plus fluoxetine therapy was effective in the treatment of menopausal depression with a satisfactory safety profile.     

盐酸氟西汀联合雌激素治疗绝经期抑郁症的临床观察

目的观察盐酸氟西汀联合利维爱用于绝经期抑郁症的疗效.方法将已绝经并符合抑郁症诊断的患者60例,随机分为两组,每组30例.联合治疗组用盐酸氟西汀和利维爱、对照组用利维爱进行治疗.治疗开始日及治疗第1月末和第2月末各随访1次,应用Zung氏抑郁自评量表(SDS)评价抑郁症程度,应用Kupperman绝经指数(KMI)评价绝经期症状.结果60例绝经期抑郁症患者中,轻度抑郁42例(70.0%),中度抑郁15例(25.0%),重度抑郁3例(5.0%).开始治疗前,联合治疗组和对照组的SDS评分比较,差异无显著性(P＞0.05).治疗后第1月末和第2月末联合治疗组SDS评分分别低于对照组,差异非常显著(P＜0.01).开始治疗前,联合治疗组和对照组的KMI评分比较,差异无显著性(P＞0.05).治疗后第1月末和第2月末联合治疗组KMI评分分别低于对照组,差异非常显著(P＜0.01).联合治疗组的有效率96.66%,对照组的有效率46.66%,差异非常显著(P＜0.01).结论盐酸氟西汀联合利维爱对绝经期抑郁症的治疗效果较好,值得临床推广应用.     

重复经颅磁刺激联合脑波同步疗法对产后抑郁症疗效及激素水平的影响

目的 观察脑波同步、重复经颅磁刺激联合氟西汀与单纯氟西汀治疗产后抑郁的疗效差异。 方法 选取2013年6月-2015年6月杭州市第七人民医院48例产后抑郁症患者采用随机数字表法分成2组,联合组(25例)予以脑波同步、重复经颅磁刺激,联合药物氟西汀治疗;氟西汀组(23例)予以单纯药物治疗。采用汉密尔顿抑郁量表(HAMD)、爱丁堡产后抑郁量表(EPDS)、临床疗效总评量表(CGI)、不良反应量表(TESS)于治疗前及治疗第1、2、4、6周末进行评分,比较2组疗效与不良反应;于治疗前及治疗第6周末检测2组患者血清皮质醇(COR)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促甲状腺激素(TSH)、雌二醇水平变化。 结果 联合组于治疗第2、4、6周末HAMD、EPDS得分下降快于氟西汀组(P<0.01);联合组在治疗2周后CGI疗效指数(EI)高于氟西汀组(P<0.05),联合组在治疗6周后CGI疗效总评指标(GI)和疗效指数(EI)方面与氟西汀组相比差异有统计学意义(P<0.05);联合组于治疗4、6周后TESS评分均明显低于氟西汀组;联合组于治疗6周后血清TSH、COR、雌二醇水平较氟西汀组差异具有统计学意义(P<0.05)。 结论 脑波同步、重复经颅磁刺激联合氟西汀治疗产后抑郁具有起效快、药物用量少、不良反应少、患者依从性好等优点。      

氟西汀加高压氧治疗脑卒中后抑郁及对认知功能的影响

目的观察氟西汀加高压氧治疗脑卒中后抑郁的临床疗效及对认知功能的影响。方法选择90例脑卒中后抑郁患者随机分为氟西汀组、高压氧组与治疗组,每组30例。各组患者经内科常规治疗,氟西汀组、高压氧组分别加用氟西汀、高压氧治疗,治疗组患者在内科常规治疗基础上,应用氟西汀加高压氧治疗。并于治疗前后行汉密尔顿抑郁量表（HAMD）、简易智能精神状态量表（MMSE）评分。结果治疗组HAMD、MMSE评分改善,各组治疗后比较有显著性差异（P〈0．01,P〈0．05）;治疗组治疗前后比较,亦有显著性差异（P〈0．01）。结论氟西汀加高压氧能明显治疗脑卒中后抑郁并改善患者的认知功能,且其效果优于单纯加用氟西汀或者高压氧治疗。     

Use of hormone replacement therapy among cardiac patients at a Canadian academic centre

BACKGROUND: Although hormone replacement therapy (HRT) is associated with a reduced risk of coronary artery disease (CAD), use of this treatment among post-menopausal women is not widespread. The authors sought to determine the extent of HRT use in a select population of women at high risk for CAD. METHODS: A cross-sectional survey was performed involving all consecutive post-menopausal women who attended a cardiology clinic in a Toronto teaching hospital between January 1996 and August 1997. A chart review was followed by a telephone interview with the patients or their physicians. The utilization rate of HRT was obtained. Predictors of HRT use were identified using a multivariate logistic regression model. RESULTS: A total of 80 women with risk factors for CAD, symptoms suspicious of CAD or definite CAD diagnosed after cardiac investigations were included in the survey. Information on HRT use or nonuse was documented in 17 (21%) of the charts. Of the 72 women for whom data on HRT were available 16 (22%) were currently using it, 41 (57%) were not, and 15 (21%) had used it in the past. Five women (7%) were receiving HRT but there was no chart documentation. On multivariate analysis, younger women were more likely than older women to use HRT (odds ratio 0.91, 95% confidence interval 0.22-0.96; p < 0.05). Coronary risk profile, CAD diagnosis and history of hysterectomy were not associated with HRT use. Of the 41 women who had never received HRT 10 (24%) had possible contraindications (e.g., breast cancer or deep vein thrombosis); the proportion was similar in the group of women who were current or past users of HRT (29%). INTERPRETATION: Documentation of HRT use in patient charts is lacking. Few women in the study who were at risk for CAD were currently using HRT. The data support the need for better adherence to optimal practices in the management of women at high risk for CAD.     

耳穴贴压联合心理干预对激素替代治疗女性围绝经期综合征疗效的影响

目的 观察耳穴贴压加心理干预对激素替代(HRT)治疗围绝经期综合征(MPS)临床疗效的影响.方法 选择我院确诊的MPS患者64例,按就诊顺序随机分为2组,每组32例.观察组为耳穴贴压加心理干预配合激素替代治疗(口服补佳乐),对照组为单纯口服补佳乐治疗.对比2组治疗前、后的绝经症状变化(Kuppernann评分)及汉密顿抑郁评分(HAMD评分)变化,并检测干预前后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平变化.结果 2组治疗后Kuppernann评分及HAMD评分较治疗前明显下降(P<0.05);观察组治疗后Kuppernann评分及HAMD评分明显低于对照组(P<0.05);2组治疗后FSH、LH、E23、P水平均明显改善(P<0.05),但组间比较差异无统计学意义(P>0.05).结论 耳穴贴压加心理干预配合激素替代治疗可有效改善围绝经期患者临床症状及抑郁状态.     

氟西汀合用小剂量奥氮平治疗重性抑郁障碍的疗效和安全性研究

目的 探讨氟西汀合用小剂量奥氮平治疗无明显精神病性症状的重性抑郁障碍的疗效和耐受性.方法 将73例符合DSM-Ⅳ重性抑郁障碍诊断标准的患者随机分成氟西汀合用奥氮平治疗组(下称研究组)和氟西汀治疗组(下称对照组),氟西汀(20～40mg)和奥氮平(2.5～10mg)采用可变剂量,治疗8周,采用汉密尔顿(HAMD)抑郁量表(17项)、临床疗效总评量表(CGI-SI)评定病情严重程度和疗效,采用副反应量表(TESS)评定不良反应.结果 平均起效时间研究组快于对照组[(10.2±8.1)d,(14.4 ±7.9)d;t=2.3,P＜0.05].在治疗后第1,2,4,6周末HAMD减分率差异有显著性(均P＜0.05),但2组在治疗结束的第8周末HAMD减分率差异无显著性(t值为0.60,P＞0.05).结论 氟西汀合用奥氮平治疗重性抑郁障碍疗效优于单纯使用氟西汀,起效时间明显缩短.     

奥氮平合并氟西汀治疗抑郁症的疗效及安全性分析

目的 观察奥氮平合并氟西汀治疗抑郁症的疗效和安全性。方法 将76例符合中国精神疾病分类方案与诊断标准第3版抑郁发作诊断标准的患者随机分为两组：氟西汀组38例，予氟西汀2～40mg／d，口服，实际完成37例；合并奥氮平组38例，予氟西汀20～40mg／d，口服，合并奥氮平2．5～10mg／d，口服，实际完成36例，均治疗观察8周。结果 两组患者汉密尔顿抑郁量表（HAND）总分及减分率的差异在治疗第4天就有统计学意义，而且这种差异在每个访视期均存在（P〈0．05或0．01）；合并奥氮平组在治疗第1、2、4周末的有效率均较氟西汀组高P〈0．05或0．01）；两组治疗8周末有效率（89．2％、86．5％）和痊愈率（75．0％、64．9％）差异无统计学意义（均P〉0．05）；两组不良反应程度均较轻，总体发生率的差异无统计学意义（均P〉0．05）。结论 奥氮平合并氟西汀治疗抑郁症是一种快速、有效，安全治疗的新方法。     

氟西汀与阿米替林治疗脑卒中后抑郁的对照研究

目的：比较氟西汀和阿米替林治疗脑卒中后抑郁（PSD）的疗效和安全性。方法：将75例有脑卒中病史且符合CCMO-3中抑郁症诊断标准的患者随机分为两组，其中用氟西汀治疗37例（研究组），阿米替林治疗38例（对照组）进行6W的双盲对照研究，于治疗前及治疗第2、4、6W末采用汉密尔顿抑郁量表、临床总体量表一疗效总评量表评定临床疗效．副反应量表评定药物不良反应。结果：两组治疗第2W末汉密尔顿抑郁量表评分较治疗前明显降低，两组间比较差异有显著性（P〈0．05）。第6W末两组间差异无显著性（P〉0．05），氟西汀组的不良反应少且轻。结论：氟西汀不良反应小，起效快，服用安全，可以提高患者的依从性，更适用于PSD的治疗。     

万拉法新与氟西汀治疗老年抑郁症对照研究

目的比较万拉法新与氟西汀治疗老年抑郁症的临床疗效和不良反应。方法将60例符合CCMD-3抑郁症诊断标准的老年患者随机分成两组,分别给予万拉法新及氟西汀治疗,疗程6周,于治疗前及治疗后1,2,4,6周末分别用汉密顿抑郁量表(HAMD)、临床疗效总评量表(CGI)及不良反应症状量表(TESS)进行评定。结果万拉法新组抗抑郁作用起效快,在第1,2周末HAMD评分低于氟西汀组,差异有显著性(t值分别为2.14和2.02,P<0.05)。经过6周治疗,万拉法新组显效率80.0%,氟西汀组显效率66.7%,差异无显著性(2=1.36,P>0.05)。不良反应均较轻微,两组差异无显著性。结论万拉法新是一种安全有效的抗抑郁药,可以作为治疗老年抑郁症的第一线抗抑郁药使用。