曲唑酮治疗老年期抑郁症的研究

目的探讨曲唑酮治疗老年期抑郁症的疗效。方法 60例符合诊断标准的老年期抑郁症患者随机分为曲唑酮组和文拉法辛组,疗程8周。采用汉密尔顿抑郁量表（HAMA）,评定疗效。采用治疗中需处理的不良反应症状量表（TESS）评定安全性。结果在第1周末研究组（曲唑酮组）有效率为30.00%;对照组（文拉法辛组）有效率为10.00%。两组有效率有显著性差异（χ2=3.85、P〈0.05）。治疗8周末研究组总有效率93.33%,对照组总有效率86.67%,两组总有效率无显著性差异（χ2=0.187、P〉0.05）,说明两者总体疗效相当。两组TESS评分在治疗后1、2、4及8周末差异均无统计学意义（P〉0.05）。结论曲唑酮治疗老年期抑郁症起效快,安全性好,副作用少。     

曲唑酮治疗心理性勃起功能障碍的功能磁共振研究

目的用功能磁共振技术结合药物磁共振技术研究正常男性和心理性勃起功能障碍患者中枢神经系统激活的差异,探讨曲唑酮治疗心理性勃起功能障碍的可能机制。方法A组为30例健康成年男性志愿者,均为右利手;30例心理性勃起功能障碍患者单盲、随机分为B组（用曲唑酮治疗7周）和C组（用安慰剂治疗7周）,每组15个患者,所有患者人均为右利手。A组仅进行一次功能磁共振检查;B组和C组在治疗前后均进行功能磁共振检查,治疗前B组和C组不服用任何药物;治疗后B组患者在磁共振扫描前60分钟服用曲唑酮100mg;C组服用安慰剂100mg。所有参与者均用色情录像和非色情录像刺激,用GE1.5TMR扫描系统进行血氧水平依赖的功能磁共振扫描。结果在色情录像的刺激下,与正常男性相比,心理性勃起功能障碍（ED）患者（B组＋C组）双侧前扣带回激活范围明显增大（t=6.715,P〈0.001）,两者存在显著性差异。B组经曲唑酮治疗后,在曲唑酮的干预下,心理性ED患者的双侧前扣带回激活被抑制与正常人接近,而双侧海马激活范围较前增大,双侧脑岛的激活被抑制;B组病人治疗前后前扣带回激活体积存在显著性差异（t=1.930,P〈0.05）;双侧海马激活较前明显,前后激活体积存在显著性差异（左侧：t=3.790,P〈0.001;右侧：t=4.203,P〈0.001）;脑岛的激活被抑制。C组病人治疗前后在安慰剂的干预下,脑激活图前后无明显改变。结论心理性ED患者在中枢神经系统可能存在潜在的病因;脑岛、前扣带回、海马可能富含5-HT受体;曲唑酮对心理性ED的治疗可能在于调节了脑岛、前扣带回、海马的神经元生物活性;曲唑酮对不同亚型的5-HT受体的调节具有多肽性。     

曲唑酮治疗老年期失眠症的临床观察

目的探讨曲唑酮治疗老年期失眠症的临床疗效和安全性。方法将60例门诊老年失眠症病人随机分为曲唑酮组（治疗组）和地西泮组（对照组）,每组各30例,疗程6周。于治疗前及治疗6周末评定病人的睡眠状况,并采用汉密尔顿抑郁量表（HAMD）、焦虑量表（HAMA）评价临床疗效,同时采用副作用量表（TESS）评价不良反应,进行比较分析。结果治疗组总有效率为86.67%,对照组总有效率为83.33%,两组之间差异无显著性（χ^2=0.612,P〉0.05）;与治疗前相比,治疗组及对照组治疗后HAMA、HAMD评分均显著降低（t=7.19～9.43,P〈0.01）;治疗组和对照组治疗前后HAMA、HAMD评分的下降值比较,差异均有显著性（t=4.21、5.13,P〈0.05）;两组不良反应相当,均较轻微,不影响治疗。结论曲唑酮能有效缓解老年失眠及伴随的病人的焦虑、抑郁情绪,无副作用,值得临床推广。     

Evaluation of cytogenetic and DNA damage induced by the antidepressant drug-active ingredients,trazodone and milnacipran,in vitro

Trazodone and milnacipran are the active antidepressant drugs that are being used in the treatment of psychiatric disorders. In this study, the in vitro genotoxic effects of trazodone and milnacipran have been determined in human peripheral blood lymphocytes by using chromosomal aberrations (CAs), sister chromatid exchanges (SCEs), micronuclei (MN), and comet assays. 3.13; 6.25; 12.50; 25.00; 50.00; and 75.00?μg/mL concentrations of trazodone and 2.50; 5.00; 10.00; 20.00; 30.00; and 40.00?μg/mL concentrations of milnacipran were used. Trazodone and milnacipran significantly increased the frequency of CAs and SCEs compared with the control. Both of the active ingredients raised the MN frequency in a dose-dependent manner. Mitotic index was significantly decreased, but replication and nuclear division indices were not affected at all treatments. Trazodone was statistically increased the mean comet tail intensity, tail length, and tail moment at three concentrations (6.25; 12.50; and 25.00?μg/mL) compared with control. Two highest concentrations (50 and 75?μg/mL) of trazodone were toxic in the comet assay. Milnacipran increased the comet tail intensity, tail length, and tail moment at all concentrations. It is concluded that trazodone and milnacipran have clastogenic, mutagenic, and cytotoxic effects on human lymphocytes in vitro.     

曲唑酮治疗继发性早泄疗效相关文献的系统评价

目的参照Cochrane体系,系统评价曲唑酮治疗继发性早泄患者的相关文献,探讨曲唑酮治疗继发性早泄的临床疗效。方法通过检索1995年1月至2015年1月期间中国学术期刊数据库等8个数据库内相关的随机对照试验(RCT),严格评价纳入文献质量和资料提取,使用Stata/SE version 12.0软件进行系统评价。结果最终纳入7篇RCT,共542例患者,其中实验组203例(予以曲唑酮)、对照组194例(予以安慰剂)。系统评价结果显示:相比使用安慰剂的对照组,经曲唑酮治疗后第2周的阴道内射精潜伏期显著延长[SMD 1.28,95%CI(0.98,1.57)],第4周的阴道内射精潜伏期显著延长[SMD 4.09,95%CI(2.56,5.62)],并且患者对性生活的满意度显著提升[RR1.39,95%CI(1.07,1.79)];经偏倚性验证,上述结论稳健,具有推广性。结论经曲唑酮治疗继发性早泄,能显著延长患者的阴道内射精潜伏期、提升患者性生活满意度,其疗效确切,值得临床推广。     

联合用药在慢性非细菌性前列腺炎治疗中的应用

目的探讨联合用药在治疗慢性非细菌性前列腺炎患者中的有效性。方法对90例慢性非细菌性前列腺炎患者采用左氧氟沙星+盐酸特拉唑嗪+曲唑酮口服治疗,疗程4～8周。应用美国国立卫生研究院(NIH)慢性前列腺炎症状评分(NIHCPSI)标准对治疗前后总评分及所包括的患者的疼痛评分、排尿症状评分、生活质量评分,并进行统计学分析。结果多数患者症状有明显改善,全部病例治疗前后NIHCPSI总评分分别为(26.60±4.69)分、(14.09±5.31)分(P<0.01);疼痛不适评分分别为(12.9±2.6)分、(8.8±3.6)分(P<0.01);排尿症状评分分别为(5.71±1.99)分、(2.89±1.48)分(P<0.01);生活质量评分分别为(9.12±3.14)分、(4.38±2.50)分(P<0.01)。结论联合用药治疗慢性非细菌性前列腺炎效果明显。     

Trazodone and triazolam: acute subject-rated and performance-impairing effects in healthy volunteers

The present study compared the acute subject-rated and performance-impairing effects of trazodone and triazolam in seven healthy humans. Trazodone (50, 100 and 200 mg), triazolam (0.125, 0.25, 0.50 mg) and placebo were administered orally in a double-blind, crossover design. Drug effects were measured approximately 30 min before drug administration and repeatedly afterwards for 6 h. Trazodone and triazolam produced dose-related increases in subject-ratings of drug effect and sedation. The absolute magnitude of trazodone”s and triazolam”s effects was comparable across these measures, which suggests the doses tested were equivalent on some behavioral dimension. By contrast, triazolam, but not trazodone, increased subject ratings of “dizzy”, “excited”, “nervous”, “restless”, “stomach turning” and “itchy skin”. Triazolam, but not trazodone, significantly impaired learning, recall and performance. The present findings suggest trazodone may be a viable alternative to benzodiazepine hypnotics like triazolam, especially when needing to minimize drug-induced impairment. Future research could extend the present findings by replicating them in a clinically relevant population such as individuals with histories of drug abuse. Received: 9 May 1996 / Final version: 15 September 1996     

盐酸曲唑酮联合西地那非治疗早泄的疗效观察

目的:探讨盐酸曲唑酮联合西地那非并配合心理行为治疗早泄的临床疗效。方法:68例早泄患者随机均分为实验组(盐酸曲唑酮加西地那非加行为疗法)和对照组(盐酸曲唑酮加行为疗法),记录治疗前后阴道内射精潜伏期并进行组内和组间比较,同时记录夫妻对性生活的满意情况。结果:治疗前,实验组和对照组阴道内射精潜伏期分别为(0.79±0.34)min、(0.85±0.38)min,治疗后分别为(4.32±2.30)min、(2.84±1.45)min,差异有统计学意义(P<0.01),且实验组阴道内射精潜伏期较对照组相比差异有统计学意义(P<0.01)。夫妻双方对性生活的情况:满意率实验组(64.5%)明显高于对照组(35.3%),差异有统计学意义(P<0.05),而总满意率(满意加基本满意)实验组(84.6%)亦高于对照组(70.6%),但差异无统计学意义(P>0.05)。结论:盐酸曲唑酮联合西地那非并配合心理行为疗法在延长射精潜伏期,改善夫妻双方性生活满意度方面明显优于盐酸曲唑酮配合心理行为疗法,两药合用在治疗早泄方面有一定的应用前景。     

曲唑酮治疗焦虑症20例临床分析

目的 验证曲唑酮对焦虑症的疗效。方法 应用曲唑酮治疗20例焦虑症，应用焦虑自评量表(SAS)及Hamilton焦虑量表(HAMA)评定疗效，并作临床疗效评定。结果 治疗后SAS、HAMA分值均明显下降，临床疗效评定显示痊愈率为45％，总有效率为95％，除出现困倦4例、嗜睡2例外，未见不良反应。结论 曲唑酮治疗焦虑症疗效肯定，且副作用轻微。