小剂量文拉法辛治疗抑郁障碍患者性别差异研究

目的观察小剂量文拉法辛治疗抑郁障碍的疗效、副反应在性别上的差异。方法42例抑郁障碍患者按性别分组,男性组20例,女性组22例,入组患者使用盐酸文拉法辛50~75 mg.d-1,疗程6周,以汉密尔顿抑郁量表(HAMD)在治疗前及治疗后2、4、6周各评定1次疗效,观察记录过程中不良反应的发生情况并以副反应量表(TESS)评定药物不良反应。结果男性组显效率(95%)明显高于女性组(72.7%,P<0.05);两组治疗前及治疗2周HAMD评分比较无显著差异(P>0.05),两组治疗4周和6周时与治疗前HAMD评分比较均有显著差异(P<0.05),男性组治疗4周和6周时HAMD评分低于女性组(P<0.05)。治疗1周后,女性组副反应发生率明显高于男性组(P<0.05)。结论小剂量文拉法辛治疗抑郁障碍临床疗效肯定,但存在明显的性别差异,副反应较少,且副反应发生率也存在明显的性别差异,提示对女性患者在抗抑郁治疗过程中应根据其性格特点多辅以心理治疗,并加强对症处理。

Sex differences of low dosage of Venlafaxine for treatment of depressive disorder

Objective To observe sex differences in efficacy and side reaction of low dosage Venlafaxine for treatment of depressive disorder.Methods Forty-two patients with depressive disorder were divided according to gender: male group including 20 patients and female group including 22 patients.All patients were administered with 50～75 mg·d~(-1) Venlafaxine for 6 weeks.Efficacy was evaluated before treatment and 2,4 and 6 weeks after treatment by Hamilton's depression scale(HAMD),occurrence of side reactions were observed and recorded during course of treatment and drug adverse reaction was evaluated by treatment emergent symptom scale(TESS).Results Excellence rate in male group(95%) was obviously higher than that in female group(72.7%)(P<0.05).There was no significant difference in HAMD scores before treatment and 2 weeks after treatment in two groups(P>0.05).There were obvious differences in HAMD scores between 4 weeks and 6 weeks of treatment and before treatment(P<0.05).HAMD sores in male group were lower than those in female group 4 weeks and 6 weeks of treatment(P<0.05).Occurrence rate in female group was obviously higher than that in male group after 1 week of treatment(P<0.05).Conclusion It is affirmative efficacy of small dosage Venlafaxine for treatment of depressive disorder,howerever,there are predominant sex differences,few side reactions and there is sex difference in side reaction,which indicates combination of psychological treatment and symptomatic treatment is performed for treatment of female depressive disorder according to their character.