噻奈普汀、帕罗西汀治疗老年抑郁症疗效研究

目的：观察噻萘普汀（达体朗）治疗老年抑郁症的疗效和安全性。方法：随机将50例老年抑郁症患者分为噻奈普汀组、帕罗西汀组各25例。疗程6周，采用汉密尔顿抑郁量表（HAMD）和副反应量表（TESS）法，在治疗前，治疗后第1，2，4，6周，分别评定药物疗效和不良反应。结果：两组疗效差异不显著，HAMD总分及各因子分再治疗后2～6周均较治疗前显著降低（P〈0．01），治疗结束时TESS评分噻奈普汀组低于帕罗西汀组（P〈0．01）。结论：该药治疗老年抑郁症疗效好，不良反应少。     

噻奈普汀与氟西汀治疗抑郁症的对照研究

目的　探讨噻奈普汀和氟西汀治疗抑郁症的疗效和不良反应。方法　 6 0例病人 ,随机分为两组。氟西汀组 30例 ,男性 17例 ( 5 6 .7% ) ,女性 13例 ( 4 3.3% ) ,予以氟西汀 2 0 mg/ d,po;噻奈普汀组 30例 ,男性 18例( 6 0 % ) ,女性 12例 ( 4 0 % ) ,予以噻奈普汀 12 .5 mg,po,tid;疗程为 8周 ,治疗前及治疗第 2、4、6、8周末采用 HAMD,TESS评定疗效及不良反应。结果　氟西汀显效率 90 .0 % ,噻奈普汀显效 82 .8% ( P>0 .0 5 ) ,不良反应也无明显差异。结论　噻奈普汀是一种有效的治疗抑郁症的药物 ,且不良反应少     

噻奈普汀与氟西汀治疗抑郁症疗效与安全性分析

目的探讨了噻奈普汀与氟西汀治疗抑郁症疗效与安全性分析。方法 120例抑郁症患者随机分为两组,氟西汀组和噻奈普汀组,实验组60例,采用噻奈普汀进行治疗,氟西汀组患者60例,采用氟西汀进行治疗,治疗8周后,采用汉密尔顿抑郁量表对药物的治疗效果进行评价,采用不良反应量表对药物的不良反应进行评价。结果噻奈普汀组和氟西汀组的治疗有效率分别,两组相比较差异没有统计学意义(P<0.05)。两组患者在治疗2周后开始起效,噻奈普汀组在2、4和8周的汉密尔顿抑郁量减分率明显高于氟西汀组(P<0.05)。噻奈普汀组的主要毒副反应表现为口干、难以入睡、胃肠道反应、头痛、便秘等,与氟西汀组相比较,毒副作用明显较轻。结论 :噻奈普汀治疗对抑郁症疗效显著,毒副作用较低,优于氟西汀。     

噻奈普汀与阿米替林治疗抑郁症的系统评价

目的 系统评价噻奈普汀与阿米替林治疗抑郁症的疗效与安全性。方法 检索从建库至2016年3月,中国期刊全文数据库（CNKI）、万方数据库、中文科技期刊全文数据库（VIP）、Cochrane library、PubMed/Medline等数据库中噻奈普汀与阿米替林治疗抑郁症的随机对照试验（RCTs）,采用RevMan 5.0软件对各效应指标进行Meta分析。结果 共纳入6篇RCTs,714例患者,其中噻奈普汀组（治疗组）359例,阿米替林组（对照组）355例;Meta分析结果显示噻奈普汀组与阿米替林组显效率差异无显著性[OR=1.56,95% CI（0.87~2.79）,P=0.13];两组头晕、口干、恶心呕吐、烦渴、便秘、震颤、排尿困难等不良反应差异有显著性（P<0.05）,95% CI上下限均小于1,提示噻奈普汀组在上述不良反应发生率方面小于阿米替林组;其他不良反应无显著性差异。结论 噻奈普汀与阿米替林治疗抑郁症疗效相当,但噻奈普汀不良反应较轻微;该结论尚需高质量、严格设计的RCTs进一步证实。     

噻奈普汀与氟西汀对照治疗抑郁症患者的系统评价

目的 系统评价噻奈普汀与氟西汀治疗抑郁症的疗效和安全性。方法 计算机检索中国期刊全文数据库、维普全文数据库、万方数据库、PubMed、Medline、EMBase中关于噻奈普汀与氟西汀治疗抑郁症的随机对照试验(RCT),对纳入的RCT采用Cochrane系统评价的方法进行评价,采用RevMan 5.0统计软件进行Meta分析。结果 共纳入5项研究,合计942例患者,meta分析结果显示,噻奈普汀组患者有效率[OR=1.25,95%CI(0.93,1.66),P=0.13]与氟西汀组比较差异无统计学意义;在不良反应发生率方面,2组比较差异有统计学意义[OR=0.53,95%CI(0.36~0.77),P<0.001]。结论 噻奈普汀与氟西汀治疗抑郁症疗效相当,不良反应少。但该结论尚需高质量、设计严谨的RCT进一步证实。     

噻奈普汀合用黛力新与氟西汀治疗抑郁症疗效对比观察

目的:观察噻奈普汀和黛力新联合应用治疗抑郁症的疗效.方法:159例患者随机分为两组.噻奈普汀和黛力新联合组81例(噻奈普汀37.5mg/d,黛力新2片/d),氟西汀组78例(20m~d).疗程均为6周.采用汉密尔顿抑郁量表(HAMD24)评定临床效果,采用不良反应量表(TESS)评定临床安全性.结果:噻奈普汀和黛力新联合组和氟西汀组总有效率分别是85.2％和64.1％.差异显著(P＜0.01).联合组起效时间1周,氟西汀组4周.联合组在治疗1、2、4、6周时的HAMD减分率均高于氟西汀组,差异显著(P＜0.01).联合组的副作用与氟西汀组比较差异不显著(乃0.05).结论:噻奈普汀和黛力新联合应用是治疗抑郁症有效、起效快的方法,安全性和依从性良好.     

噻奈普汀的临床应用

本文通过查阅近期国内外相关文献．从作用机制、药理特性、与其他抗抑郁药的比较及安全性等方面对噻奈普汀进行了分析和评价．认为噻奈普汀具有疗效好、不良反应少等特点,可以作为治疗抑郁症的一线药物。     

噻奈普汀与阿米替林治疗老年抑郁症的对照研究

目的:探讨噻奈普汀治疗老年抑郁症的疗效及安全性。方法:对62例老年抑郁症病人随机分为两组,分别给予噻奈普汀与阿米替林治疗6周。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效,用不良反应量表(TESS)评定不良反应。结果:噻奈普汀与阿米替林疗效相似,没有严重不良反应。结论:噻奈普汀治疗老年抑郁症疗效好,不良反应轻,患者药物依从性好。     

噻奈普汀联合氟哌噻吨美利曲辛治疗抑郁症方案应用研究

目的观察噻奈普汀联合氟哌噻吨美利曲辛治疗中重度抑郁症的疗效和安全性。方法采用开放随机分组对照研究的方法。将2007年3月至2008年6月360例中重度抑郁症患者按随机数字表法分为噻奈普汀联合氟哌噻吨美利曲辛组（A组）110例,氟西汀联合氟哌噻吨美利曲辛组（B组）95例,单用噻奈普汀组（C组）72例,单用氟西汀组（D组）83例。4组采用相应治疗,分别于1、2、4、6周末采用汉密尔顿抑郁量表（HAMD）评定临床疗效,采用抗抑郁药副反应量表（SERS）及检查肝、肾功能及心电图的结果综合评定安全性。结果第6周末A组总有效率为89．09％;B组总有效率为78．94％;C组总有效率为73．61％;D组总有效率为66．27％。A组与B组差异有统计学意义（χ2=3．98,P〈0．05）;A组与C组比较差异有统计学意义（χ2=7．37,P〈0．01）;A组与D组比较差异有统计学意义（χ2=15．00,P〈0．01）。第1周末只有A组HAMD减分率〉50％,A组第1周治疗前后HAMD减分率差异有统计学意义（P〈0．01）,而且明显高于B、C、D组第1周减分率。4组减分率相比较,差异均有统计学意义（P〈0．01）。A组起效时间为第一周末。B、C、D组起效时间均在两周以上。4组均有口干、头痛、便秘等不良反应,A、C组不良反应发生率对比,差异无统计学意义（P〉0．05）,提示联合用药没有增加不良反应。结论噻奈普汀联合组治疗中重度抑郁症具有良好的疗效和安全性。且在治疗第一周内起效,可迅速提高患者对治疗的依从性,使患者早期树立信心,更好地配合治疗。     

前列腺炎伴性功能障碍的治疗体会

目的 探讨心理干预对慢性前列腺炎（CP）伴性功能障碍（ED）的治疗效果.方法 选取2009年1月-2012年12月我院泌尿外科门诊CP伴ED患者46例,年龄25～52岁.随机分为Ⅰ组、Ⅱ组两组,每组23例.两组患者同时给予坦洛新治疗.Ⅰ组患者：单纯给药组.Ⅱ组患者：药物治疗的同时给予心理干预的综合疗法.结果 两组患者治疗前后,CP症状评分（CPSI）均值及国际勃起功能问卷评分（IIEF-5）均有明显改善,差异有统计学意义（P＜0.01）,两组患者治疗后CPSI评分均值比较差异无统计学意义（P＞0.05）,而IIEF-5评分比较,Ⅱ组改善情况明显好于Ⅰ组,差异有统计学意义（P＜0.01）.结论 药物治疗对改善CP伴ED症状具有良好效果,而在治疗过程中良好的心理干预治疗对于患者的康复起到至关重要的作用.     

Switching to tianeptine in patients with antidepressant-induced sexual dysfunction

Sexual side effects are frequent and are recently being considered as effects of antidepressant treatment. One method to improve the sexual dysfunction associated with the use of antidepressants is to change to another antidepressant. In the present work, the consequences of switching to tianeptine in patients with antidepressant-induced sexual dysfunction were studied. The study group comprised 23 patients with major depressive disorder who experienced antidepressant-induced sexual dysfunction. These antidepressants were stopped and switched to tianeptine (12.5mg x 3/day). All patients were screened by using the clinical global impression-improvement scale (CGI-I), the Hamilton depression rating scale (HAM-D) and the Arizona sexual experience scale (ASEX) at the beginning of the study, and at weeks 4 and 8. No patient failed to tolerate 37.5mg of tianeptine or to complete the study except for one patient becoming pregnant. Paired t-tests revealed a significant difference between baseline and week 4 or week 8 in scores on both the HAM-D and ASEX. At 8 weeks, six patients were rated as very much improved (CGI-I=1) and ten patients were rated as much improved (CGI-I=2). Thus, with a CGI-I score of 2 or less used to indicate a positive response, 72.7% of the patients were responders. The results suggest that switching to tianeptine appears to be useful for alleviating sexual dysfunction caused by other antidepressants.     

2种文拉法辛制剂治疗抑郁症的对照研究

目的:研究2种文拉法辛制剂治疗抑郁症的疗效和安全性。方法:入组病例符合CCMD-2R抑郁症诊断标准,随机分为试验组(文拉法辛缓释胶囊)30例,对照组(文拉法辛胶囊)30例,用HAMD、HAMA、TESS量表评价疗效和不良反应。结果:2组药物均对抑郁症治疗效果良好,2组病人的HAMD评分自治疗后1wk起均有明显改善。试验组HAMD减分率自2wk末开始明显高于对照组(P<0.05), HAMA减分率自治疗后1wk末即明显高于对照组(P<0.01),显效率87％,有效率97％,均高于对照组,TESS评分对照组高于试验组,但无严重不良反应,不影响治疗。结论:文拉法辛缓释胶囊治疗抑郁症起效快,疗效好,不良反应少,服用方便,依从性好。     

Tianeptine and fluoxetine in major depression: a 6-week randomised double-blind study

In a 6-week, multicentre, randomised, double-blind controlled study, tianeptine (37.5 mg/day) and fluoxetine (20 mg/day) were compared for efficacy and safety in 178 patients with major depression. No significant difference was shown between the two drugs, either in terms of efficacy (MADRS, CGI, COVI) or in terms of safety, except for the CGI 'severity of illness' which was lower at the end point with tianeptine than with fluoxetine. The percentages of responders (as defined by a 50% decrease of the MADRS score from baseline to end point) were 75% with tianeptine and 67% with fluoxetine, showing the efficacy of both drugs. In conclusion, both tianeptine and fluoxetine are effective and well-tolerated treatments for major depression.     

Safety of sildenafil in the treatment of erectile dysfunction in patients with obstructive sleep apnoea

Obstructive sleep apnoea, characterised by repetitive occlusion of the upper airway during sleep, is recognised as a risk or even an aetiological factor for erectile dysfunction. On the other hand, sleep-disordered breathing has been reported by many patients with erectile dysfunction. Sildenafil, a very commonly used erectile dysfunction treatment, could, at least theoretically, exacerbate sleep apnoea by interfering with pharyngeal muscle tone, nasal patency and gas exchange in the lung. A recent safety study suggested a detrimental effect of oral sildenafil on respiratory events in patients with obstructive sleep apnoea. Given the inconclusiveness of evidence on pathophysiological mechanisms and the paucity of relevant clinical data the safety risk of sildenafil administration in patients with obstructive sleep apnoea should be questioned. More clinical trials are needed to clarify this issue.     

米氮平与氟西汀治疗伴有广泛焦虑障碍的抑郁症各35例的疗效比较

目的 :比较米氮平与氟西汀治疗伴有广泛焦虑障碍的抑郁症的疗效。方法 :70例同时符合DSM Ⅳ重症抑郁障碍及广泛焦虑障碍诊断标准的抑郁症病人随机分为 2组 ,米氮平组 35例 [男性 12例 ,女性 2 3例 ,年龄 (4 3±s 14 )a],予米氮平 15～4 5mg ,po ,qd。氟西汀组 35例 [男性 10例 ,女性 2 5例 ,年龄 (4 4± 12 )a],予氟西汀 2 0～ 6 0mg ,po ,qd ;均 8wk为一个疗程。结果 :米氮平组有效率为94 % (33/35 ) ,氟西汀组有效率为 89% (31/35 ) ,2组有效率比较差异无显著意义 (P >0 .0 5 )。结论 :米氮平治疗伴有广泛焦虑障碍的抑郁症 ,起效快、疗效与氟西汀相似     

米氮平与帕罗西汀治疗老年抑郁症的临床对照研究

目的比较米氮平和帕罗西汀治疗老年抑郁症的疗效及安全性。方法将70例住院老年抑郁症病人随机分为米氮平组和帕罗西汀组,各35例。米氮平起始剂量15mg·d-1,qn,1wk内加至30mg·d-1;帕罗西汀剂量为20mg·d-1,疗程均为6wk。以汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI)评定疗效,以抗抑郁药副反应量表(SERS)评定不良反应,分别在治疗前和治疗后2、4、6wk末评定一次。结果治疗前2组HAMD、病情严重程度(SI)评分无显著差异(P>0.05),治疗2、4、6wk末2组HAMD和SI评分与治疗前比较均显著下降(P<0.05或P<0.01)。治疗2wk末,HAMD和CGI评分2组间比较有非常显著差异(P<0.01);治疗4、6wk末,2组间HAMD、疗效总评(GI)和SI评分无显著差异(P>0.05),而疗效指数(EI)评分比较有显著差异(P<0.05)。治疗2、4、6wk末的SERS评分2组比较均有显著差异(P<0.05);帕罗西汀组躯体疲倦和性功能障碍发生多于米氮平组(P<0.05,P<0.01),而米氮平组发生嗜睡较多(P<0.05)。结论米氮平与帕罗西汀治疗老年抑郁症均有较好疗效,米氮平起效较快、不良反应较轻。     

Onset and duration of action of sildenafil for the treatment of erectile dysfunction

Aims  To determine the onset and duration of action of sildenafil in patients with erectile dysfunction (ED).
Methods  Two randomised, double-blind, placebo-controlled, two-way crossover studies were conducted in men with ED of no known organic cause. Study I: The time to onset of erections after sildenafil (50 mg) or placebo dosing following visual sexual stimulation (VSS) was assessed in 17 patients. Patients not achieving >60% penile rigidity by 70 min postdose as measured by a RigiScan^® monitoring device were assigned an onset time of 70 min. Study II: The duration of grade 3 (hard enough for penetration) and grade 4 (fully hard) erections, determined by self-assessment during 60 min of VSS starting 2 and 4 h after sildenafil (100 mg) or placebo dosing, was measured in 16 patients.
Results  Study I: The median time (range) to onset of erections was 27 min (in a range of 12–70) after receiving sildenafil 50 mg. In the sildenafil group, 71% of patients experienced onset of erections within 30 min of dosing, and 82% responded within 45 min. Of the patients who achieved >60% penile rigidity after sildenafil, 86% had done so by 30 min after dosing. Study II: When VSS began 2 h postdose, the median duration of grade 3 or 4 erections was 19.5 min (0–55) for sildenafil vs 0 min (0–23) for placebo. When VSS began 4 h postdose, the median duration was 5 min (0–45) for sildenafil compared with 0 min for placebo (0–27).
Conclusions  Sildenafil is an effective oral treatment for ED that produces a penetrative erection as early as 12 min and for most patients, within 30 min after dosing, and a duration of action lasting at least 4 h.