艾司西酞普兰和氟西汀治疗首发抑郁症临床疗效及认知功能影响的比较

目的 比较艾司西酞普兰和氟西汀对抑郁症治疗的临床疗效及对抑郁症患者认知功能的影响.方法 将60例抑郁症患者随机分为艾司西酞普兰组(30例)和氟西汀组(30例),进行临床对照试验,两组药物治疗量分别为10～20 mg/d,20～40 mg/d,疗程8周.采用汉密尔顿抑郁量表17项(HAMD17)、临床整体量表-疗效总评估量表(CGI-SI)为疗效指标,以词汇流畅性测验和威斯康星卡片分类测验(WCST)评定患者认知功能,不良反应症状量表(TESS)为不良反应指标.结果 第1周艾司西酞普兰组有效率为20.00% 显著高于氟西汀组有效率(3.33%)(χ2=4.04,P <0.05).第8周治疗结束时艾司西酞普兰组有效率为73.33%,氟西汀组有效率为70.00%,两组疗效差异无统计学意义(χ2=0.08,P >0.05);在治疗第8周时与基线评分相比,两组在词汇流畅性测验和WCST的总测验次数、持续错误数和随机错误数中的评分均有改善,差异具有显著性( t =1.70～6.00, P <0.05),在WCST的正确数和分类数的评分改善不明显,差异无统计学意义( t =0.29～0.66, 均P >0.05).两组之间在词汇流畅性测验和WCST各项改善间的比较,差异无统计学意义( t =0.02～0.49,均P >0.05);两组与药物相关的不良反应出现频率的差异无统计学意义(χ2=0.07,P >0.05).结论 艾司西酞普兰和氟西汀治疗抑郁症疗效相当,均能部分缓解抑郁伴发的认知功能障碍,且副作用较小、安全性好,但艾司西酞普兰起效更快,有利于迅速缓解患者症状.

The comparison study of efficacy and cognitive function between escitalopram and fluoxetine in the patients with depression

Objective To compare the effects of escitalopram and fluoxetine on clinical efficacy and cognitive function in depression patients.Methods Total 60 cases of patients with depression were randomly divided into escitalopram group(30 cases) and fluoxetine group(30 cases) . Carried on the clinical check experiment, two groups of medicine therapeutic dose respectively was 10'20 mg/d and 20'40 mg/d,and the treatment course was 8 weeks. Using HAMD17 and CGI-SI to evaluate efficient; using WCST and vocabulary fluency test to evaluate cognitive function of the two groups and using Treatment Emergent Symptom Scale and the laboratory test to evaluate adverse events. Results At 1st week, the response rate ( 20.00%) of escitalopram group were higher than this of fluoxertine group (3.33% )(χ2=4.04, P <0.05).At the end of therapy, the response rate of escitalopram group was 73.33% and fluoxertine group had a response rate of 70.00%(χ2=0.08,P >0.05). Compare the scores in the two groups before and after treatment, vocabulary fluency test and the total numbers of test, continuous errors and random errors in WCST had improved( t =1.70'6.00,P <0.05). The number of correct score and classification of pre-treatment score in WCST points had not obvious improvements( t =0.29'0.66,P >0.05). There was no significant difference between the two groups in vocabulary fluency test and WCST tests( t =0.02'0.49,P >0.05). The comparison of the adverse events frequence rates of escitalopram group and fluoxertine group had no statistical difference (χ2=0.07,P >0.05). Conclusion Escitalopram and fluoxetine have similar therapeutic efficacy and can improve cognition function of depressive patient. Escitalopram has a faster efficient time than fluoxertine which can release the symptoms promptly.