氟西汀和多虑平治疗糖尿病伴情绪障碍的对照研究

目的探讨氟西汀对伴抑郁、焦虑的糖尿病患者的疗效及对糖代谢的影响。方法105例伴抑郁、焦虑症状的糖尿病患者被随机分为氟西汀组、多虑平组和对照组,氟西汀组在维持原糖尿病治疗方案同时加用氟西汀每日1次,每次10 mg,口服;多虑平组维持原糖尿病治疗方案,同时加用多虑平片,每日中、晚各服25 mg,对照组维持原治疗方案,不应用抗抑郁剂,疗程4周,采用Zung抑郁自评量表(SDS)与Zung焦虑自评量表(SAS)评定焦虑症状及改善情况;检测空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbAIC)评价糖代谢情况。结果治疗4周后,氟西汀组和多虑平组SDS、SAS评分较治疗前降低(P<0.05),FPG、HbAIC水平较治疗前降低,有统计学意义(P<0.05),氟西汀组较多虑平组SAS、SDS评分降低更明显,存在统计学意义(P<0.05),2组间比较FPG、2hPG、HbAIC下降无显著性差异(P>0.05);对照组治疗前后SAS、SDS评分、FPG、2hPG、HbAIC无统计学差异(P>0.05)。结论氟西汀、多虑平明显改善糖尿病患者的抑郁焦虑症状,有助于控制血糖,氟西汀较多虑平副作用少。

Control study of efficacy of fluoxetine and doxepin on diabetic with mood disorder

Objective To explore the effect of fluoxetine on diabetes with depression and anxiety, and the influence of glycometabolism. Methods One hundred and five diabetic with anxiety and depression were divided into 3 groups （fluoxetine group, doxepine group, and control group） randomly. Three groups retained original treatment plan, with fluoxetine group receiving fluoxetine 10 mg by mouth, once a day, and doxepine group receiving doxepine 25 mg by mouth, serving at noon and night every day. control group receiving no thymoleptics. The therapy cycle was 4 weeks. Anxious symptom and its improved condition were evaluated by self-rating depressive scale （SDS） and self-rating anxious scale （SAS）. Detecting fasting plasma glucose （FPG） ,2 h＇s postprandial blood glucose（2hPG） and glycosylated hemoglobin（HbAIC） to estimate the condition of glycometabolism, Results After 4 weeks＇ treatment, the scores of SDS and SAS, the level of FPG and HbAIC decreased significantly in fluoxetine group and doxepine group （P 〈 0.05 ） ,but the scores of SDS and SAS in fluoxetine group decreased more significantly than that in doxepine group（ P 〈 0.05 ）. There was no obviously difference in FPG ,2hPG,HbAIC between two groups. There was no difference in the scores of SDS and SAS, the level of FPG,2hPG,HbAIC pre-and post-treatment in control group（ P 〉 0.05 ）. Conclusion Fluoxetine and doxepine can improve anxiety and depression and conduce to control blood glucose in diabetes pa- tients,and fluoxetine is better than doxepine because of slight side effects.