盐酸文拉法辛缓释片与盐酸舍曲林治疗广泛性焦虑对照研究

目的:探讨盐酸文拉法辛缓释片治疗广泛性焦虑患者的疗效及安全性。方法:将60例患者随机均分为盐酸文拉法辛缓释片组(研究组)与盐酸舍曲林组(对照组)各30例,疗程为4周,于治疗前及治疗1、2、4周末采用汉密尔顿焦虑量表(HAMA)和CGI-BP评定临床疗效,副反应量表(TESS)评定不良反应。结果:治疗4周末,研究组显效率76.7%,对照组70.0%,两组总体疗效相当(P>0.05)。汉密尔顿焦虑量表评分,两组总分均有显著下降(P<0.01),但研究组治疗2周末较对照组下降显著(P<0.05),其它时点评分均无显著性差异(P>0.05)。文拉法辛组的不良反应发生率为23.3%(7/30),盐酸舍曲林组为33.3%(10/30),差异无统计学意义(P>0.05)。结论:盐酸文拉法辛缓释片治疗广泛性焦虑疗效显著,安全性高,依从性好,且盐酸文拉法辛缓释片起效更快,但高血压患者应慎用。     

盐酸舍曲林联合脱敏治疗早泄的临床疗效分析

目的:探讨盐酸舍曲林联合脱敏治疗早泄的临床效果,为该病的治疗提供可靠的参考依据。方法:收集2012年6月至2014年6月间到医院检查的110例早泄患者作为研究对象,将其按照随机数字表法分为联合组与常规组,常规组给予盐酸舍曲林治疗,联合组给予盐酸舍曲林+脱敏治疗,对两组的临床治疗效果进行观察。结果:治疗后两组的LELT、CIPE、患者及其配偶对性生活满意度的评分均较治疗前明显的提高,组间数据差异有统计学意义(P<0.05)。联合组不良反应发生率5.5%;常规组不良反应发生率9.1%,差异无统计学意义(P>0.05)。结论:临床中对于早泄患者应用盐酸舍曲林联合脱敏治疗是可行的,能够改善早泄症状,并提高其性功能状况,值得临床中应用与推广。     

加味逍遥丸联合盐酸舍曲林治疗糖尿病伴抑郁症30例

目的：观察加味逍遥丸联合盐酸舍曲林片治疗糖尿病伴抑郁症的临床疗效。方法：将60例患者随机分为两组,对照组30例,给予盐酸舍曲林片（左洛复）,50mg/d,1次/d,治疗组30例,在西药治疗同对照组的基础上又给予加味逍遥丸,6g/次,2次/d。连续治疗8周后观测临床症状、生化指标、汉密顿抑郁量表（HAMD）,判断疗效。结果：两组空腹、餐后2h血糖和HbA1c较治疗前均有改善,HAMD评分比治疗前评分低,治疗组较对照组更显著（P〈0.01）。结论：加味逍遥丸联合盐酸舍曲林治疗糖尿病伴抑郁症效果明显优于单用西药,可缩短疗程,提高疗效,减少西药不良反应。     

盐酸舍曲林治疗早泄对性自信和性关系满意的疗效观察

目的:观察盐酸舍曲林(左洛复)治疗早泄对提高性自信和性关系满意的疗效.方法:记录62例患者服用左洛复(50mg/d)1个月治疗前后射精潜伏期时间、患者性自信评分及夫妻性生活的满意程度评分.结果:患者治疗后,射精潜伏期时间延长,性自信评分及夫妻性生活的满意程度评分显著提高,且均有显著差异性.结论:盐酸舍曲林对提高早泄患者的性自信和性关系满意度有良好的效果.     

舍曲林治疗脑卒中后抑郁的临床研究

目的:观察舍曲林治疗脑卒中后抑郁的疗效。方法:将128例脑卒中后抑郁的患者随机分为治疗组66例和对照组62例,于治疗前、后采用汉密尔顿抑郁量表(HAMD)、神经功能缺损评分量表(SSS)及日常生活能力Barthel指数量表(BI)进行分析。结果:治疗组HAMD、SSS评分较对照组明显降低,BI评分较对照组明显升高(P<0.05)。结论:舍曲林治疗脑卒中后抑郁效果明显。     

A Randomized Controlled Trial of Sertraline for the Treatment of Depression in Persons With Traumatic Brain Injury

Ashman TA, Cantor JB, Gordon WA, Spielman L, Flanagan S, Ginsberg A, Engmann C, Egan M, Ambrose F, Greenwald B. A randomized controlled trial of sertraline for the treatment of depression in persons with traumatic brain injury.

Objective

To examine the efficacy of sertraline in the treatment of depression after traumatic brain injury (TBI).

Design

Double-blind, randomized controlled trial.

Setting

Research center at a major urban medical center.

Participants

Subjects were a referred and volunteer sample of 52 participants with TBI, a diagnosis of major depression disorder (MDD), and a score on the Hamilton Rating Scale for Depression (HAM-D) of 18 or greater. The majority of the sample was male (58%), had less than 14 years of education (73%), had incomes below $20,000 (82%), and were from minority backgrounds (75%). Approximately one third of the sample had mild brain injuries, and two thirds had moderate to severe brain injuries. The mean age was 47±11, and the mean time since injury was 17±14 years. One participant withdrew from the study because of side effects.

Intervention

Daily oral sertraline in doses starting at 25mg and increasing to therapeutic levels (up to 200mg) or placebo for 10 weeks.

Main Outcome Measures

The HAM-D, the Beck Anxiety Inventory, and the Life-3 quality of life (QOL).

Results

No statistically significant differences were found at baseline between drug and placebo groups on baseline measures of depression (24.8±7.3 vs 27.7±7.0), anxiety (16.4±12.3 vs 24.0±14.9), or QOL (2.96±1.0 vs 2.9±0.9). The income level of those receiving placebo was significantly lower than those participants receiving medication. Analyses of covariance revealed significant changes from preintervention to posttreatment for all 3 outcome measures (P<.001) but no group effects. Random-effects modeling did not find any significant difference in patterns of scores of the outcome measures between the placebo and medication groups.

Conclusions

Both groups showed improvements in mood, anxiety, and QOL, with 59% of the experimental group and 32% of the placebo group responding to the treatment, defined as a reduction of a person's HAM-D score by 50%.     

盐酸舍曲林片、分散片人体生物等效性研究

 目的 评价盐酸舍曲林片、分散片在健康人体相对生物利用度及生物等效性.方法 受试者随机、自身三交叉、单剂量口服受试制剂盐酸舍曲林片、分散片和参比制剂50 mg,采用LC/MS/MS法测定血浆中药物浓度,药动学参数采用BAPP2.2软件处理获得.结果 3种制剂Cmax分别为(14.10±6.49) ng/ml、(14.17±6.02) ng/ml和(14.51±6.27) ng/ml,Tmax分别为(5.22±1.17) h、(5.11±1.68) h和(4.72±1.18) h,t1/2分别为(29.92±7.43) h、(27.55± 6.89) h和(29.04±7.52) h,AUC0 tn分别为(457.86±236.28) ng/(ml·h)、(452.62±259.41) ng/(ml·h)和(452.49±275.10) ng/(ml·h),AUC0-∞分别为(502.95±276.04) ng/(ml·h)、(493.11±299.28) ng/(ml·h)和(502.59±324.23) ng/(ml·h);相对于参比制剂,受试制剂的生物利用度F0-tn为(105.22±21.85)%和(13.26±19.00)%.受试制剂和参比制剂的Cmax、AUC0 tn和AUC0 ∞经对数转换后进行方差分析,两制剂间无显著性差异.结论 浙江京新药业股份有限公司研制的盐酸舍曲林片、盐酸舍曲林分散片与辉瑞制药有限公司生产的盐酸舍曲林片具有生物等效性.     

Alcohol drinking attenuated by sertraline in rats with 6-OHDA or 5,7-DHT lesions of N. accumbens: A caloric response?

The purpose of this study was to elucidate further the role of serotonin (5-HT) in the preference for ethyl alcohol induced in the Sprague-Dawley rat by lesions of the N. accumbens. Following a standard preference test for 3–30% alcohol, dopaminergic or serotonergic neurons in the N. accumbens of the rat were lesioned bilaterally by 6-hydroxydopamine (6-OHDA) or 5,7-dihydroxytryptamine (5,7-DHT), respectively. After recovery postoperatively, each rat was offered water and its maximally preferred concentration of alcohol, which ranged from 7% to 11%. Following a 4-day pretest, either the saline control vehicle or the 5-HT reuptake inhibitor, sertraline, was injected subcutaneously in a dose of either 3.0 or 10 mg/kg b.i.d. at 0800 and 2000 h over the next 3 days. Alcohol preference during the injection sequence and for 4 days thereafter was significantly reduced by sertraline in terms of both absolute g/kg and proportion of alcohol to water intakes. Saline was without effect on alcohol drinking. Comparisons of the drinking profiles of serotonergic versus dopaminergic lesioned rats revealed a dose dependent response to sertraline only in the 5,7-DHT lesioned animals. Although sertraline did not alter water drinking, the consumption of food declined significantly during and after its administration with a decline in body weight also observed at the higher dose. These results suggest that in addition to dopaminergic neurons in the N. accumbens, the synaptic activity of 5-HT in this structure contributes to the aberrant drinking of alcohol. However, this interpretation is tempered by the fact that caloric intake was suppressed concomitantly by the drug. Thus the presumed central action of sertraline may not be functionally specific to the reinforcing or other behavioral properties of alcohol.     

九味镇心颗粒联合舍曲林治疗产后抑郁症的疗效观察

目的评价九味镇心颗粒联合舍曲林应用于产后抑郁症的有效性和安全性。方法选取2012年8月—2015年3月在天津市安定医院就诊的产后抑郁症患者87名,随机分成对照组(43例)和治疗组(44例)。对照组口服盐酸舍曲林片,1片/次,1次/d。治疗组在对照组的基础上口服九味镇心颗粒,1袋/次,3次/d。两组患者均连续治疗8周。评价两组患者治疗前后临床疗效,比较汉密顿抑郁量表(HAMD)评分和血清雌二醇、孕酮水平。结果治疗2、4、8周后,对照组的总有效率分别为16.3%、44.2%、72.1%,均显著低于同期治疗组的36.4%、65.9%、86.4%,两组总有效率比较差异具有统计学意义(P0.05)。治疗4、8周后,两组患者HAMD评分均显著下降,且治疗2周后治疗组患者HAMD评分显著下降,同组比较差异具有统计学意义(P0.05);治疗8周后,治疗组患者HAMD评分显著低对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者雌二醇水平显著升高,孕酮水平显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者性激素水平改善效果优于对照组,两组比较差异具有统计学意义(P0.05)。结论九味镇心颗粒联合舍曲林对产后抑郁症有明显的治疗作用,具有一定的临床推广应用价值。