氟哌噻吨／四甲蒽丙胺治疗功能性消化不良的疗效观察

功能性消化不良症（FD）发病率较高,其发病机制尚不清楚。近年来,国外较多学者认为心理因素在其发病中起重要作用。为此,我们应用氟哌噻吨／四甲蒽丙胺（黛力新）合并内科常规治疗方法治疗了50例功能性消化不良的患者,现将结果报告如下。     

氟西汀和舍曲林、米氮平对抑郁障碍患者糖代谢的影响

目的 探讨氟西汀和舍曲林、米氮平对抑郁障碍患者糖代谢的影响.方法 将96例抑郁障碍患者采用随机数字表法随机分为米氮平组、氟西汀组、舍曲林组,每组32例;治疗观察期均为12周;3组患者于治疗前及治疗后第4、12周末测定血浆神经肽Y和瘦素水平,同时检测空腹血糖、胰岛素(INS)水平进行比较.结果 3组在第4周末与基数比较末出现空腹血糖过高,差异无统计学意义(P均＞0.05),而在第12周末,米氮平组空腹血糖过高,与基数比较差异有统计学意义(P均＜0.05).3组治疗前及治疗后胰岛素、NPY及瘦素与基数比较差异无统计学意义(P均＞0.05).结论 米氮平治疗既往无耱代谢异常的抑郁障碍患者可出现空腹血糖增高.     

米氮平和盐酸舍曲林治疗女性更年期抑郁障碍的随机对照研究

目的 探讨米氮平和盐酸舍曲林治疗更年期抑郁障碍的疗效.方法 将64例符合更年期首发抑郁障碍的患者随机分成米氮平组和盐酸舍曲林组.米氮平剂量1日15～45mg.舍曲林1日50～200mg,疗效采用汉密尔顿抑郁量表(HAMD),不良反应和安全性用TESS和实验室检查评定.观察时间为期6周.结果 米氮平组显效率84.38%,...     

益脑胶囊联合舍曲林治疗抑郁性神经症的疗效观察

目的 观察益脑胶囊联合舍曲林治疗抑郁性神经症的临床疗效.方法 益脑胶囊联合舍曲林治疗组30例,予益脑胶囊每次3粒,每日3次,舍曲林每次50 mg,每日1次;对照组30例,单用舍曲林,每次50 mg,每日1次.两组均4周为1个疗程,观察其疗效.结果 治疗组有效率96.7%,对照组有效率66.7%.两组比较差异有统计学意义(P<0.01).结论 益脑胶囊联合舍曲林治疗抑郁性神经症疗效确切,疗程短,见效快.     

舍曲林联合家庭治疗青少年抑郁障碍的临床研究

目的 探讨舍曲林联合家庭治疗青少年抑郁障碍的临床效果.方法 选取2020年1月至10月吉安市第三人民医院收治的80例青少年抑郁障碍患者作为研究对象,采用数字奇偶法将其分为联合组和单一组,每组各40例.联合组患者采用舍曲林+家庭治疗方式干预,单一组患者采用舍曲林药物干预.比较两组患者的简易应对方式问卷(SCSQ)评分、汉...     

舒肝解郁胶囊联合舍曲林治疗脑卒中后抑郁障碍的疗效观察

目的观察舒肝解郁胶囊联合舍曲林治疗脑卒中后抑郁障碍（PSD）的临床疗效。方法将89例脑卒中后抑郁障碍患者随机分为两组,研究组45例,给予舒肝解郁胶囊与舍曲林治疗,对照组44例,给予舍曲林治疗,6周为一疗程。于治疗前及治疗后1、2、4、6周末采用HAMD、TESS、CGI-SI分别进行评定。结果与治疗前比较：研究组在治疗后各时点的HAMD评分及CGI-SI评分均有改善（P〈0.05）;与对照组比较：研究组在治疗后各时点的HAMD评分及CGI-SI评分的改善均优于对照组（P〈0.05）。6周末疗效比较,研究组较对照组差异有统计学意义（χ2=4.68,P〈0.05）。两组治疗期间TESS评分各时点差异均无统计学意义（P〉0.05）。结论舒肝解郁胶囊联合舍曲林治疗脑卒中后抑郁障碍疗效优于单用舍曲林,且起效较快。     

帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁障碍的临床观察

目的探讨帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁障碍的临床应用价值。方法选取2015年2月至2017年10月期间我院收治的96例脑卒中后重性抑郁障碍患者作为研究对象,利用随机数字表法将其分为研究组、对照组,每组48例。对照组脑卒中后重性抑郁障碍患者在常规治疗基础上加用氟哌噻吨美利曲辛,20 mg/次,每日2次,连续服用28 d;研究组脑卒中后重性抑郁障碍患者在常规治疗基础上加用帕罗西汀,25 mg/次,1次/d,连续给药28 d,氟哌噻吨美利曲辛给药同对照组。结果两组脑卒中后重性抑郁障碍患者治疗完成率均为100.00%。两组脑卒中后重性抑郁障碍患者治疗前HAMD、NIHSS、SF-36、SCL-90量表评分对比无显著差异(P>0.05),治疗后研究组HAMD、SCL-90、NIHSS量表评分较之前下降幅度以及SF-36量表评分上升幅度均优于对照组(P均<0.05);两组各项药物相关不良反应发生率对比差异均无统计学意义,P均>0.05。结论应用帕罗西汀、氟哌噻吨美利曲辛联合治疗脑卒中后重性抑郁障碍具有较为理想的应用效果,有利于保障患者生活质量、身心健康。     

阿立哌唑联合舍曲林治疗精神分裂症合并抑郁患者的疗效分析

目的 为有效治疗精神分裂症、抑郁患者,临床探究舍曲林、阿立哌唑联合用于疾病治疗的可行性、有效性.方法 选取2013年4月至2015年7月期间本院经诊断为精神分裂症、抑郁人院治疗的80例患者,按双盲法随机分为两组,分别为单一组、治疗组,每组40例.其中单一组使用阿立哌唑,治疗组在此基础上加用舍曲林,对两组患者疾病治疗效果进行评估,同时两组治疗前后患者抑郁、精神分裂评分进行记录比较.结果 治疗组症状改善有效率95.0％,单一组为82.5％,单一组较治疗组疗效差(P＜0.05);治疗前两组PANSS、HAMD评分比较差异无统计学意义(P＞0.05),治疗后治疗组PANSS、HAMD评分低于单一组(P＜0.05).结论 临床对精神分裂症合并抑郁患者,采用舍曲林、阿立哌唑联合治疗,患者症状改善效果好.     

西酞普兰与舍曲林用于癫痫性抑郁障碍治疗临床对比研究

目的:对比西酞普兰与舍曲林治疗癫痫性抑郁障碍的临床疗效. 方法:将我院86例癫痫性抑郁障碍患者随机分为观察组和对照组各43例,观察组患者和对照组患者在常规治疗的基础上分别使用西酞普兰和舍曲林治疗,对比有效率、不良反应.结果:观察组与对照组治疗有效率分别为79.0%和74.5%,差异没有统计学意义(P>0.05);两组患者治疗以后都有不同程度的不良反应,但观察组优于对照组(P<0.05). 结论:对于癫痫性抑郁障碍治疗,西酞普兰相比舍曲林疗效肯定,副作用相对较小,可以作为临床治疗的首选药物,值得临床推广.     

舍曲林与氯米帕明治疗难治性强迫症对照研究

目的探讨舍曲林与氯米帕明治疗难治性强迫症的疗效和不良反应。方法对难治性强迫症60例,随机分为两组,分别用舍曲林与氯米帕明治疗8周。采用强迫症量表（Y-BOCS）和副反应量表（TESS）评价疗效及不良反应。结果两药的总体疗效相仿。舍曲林不良反应小,尤其是心血管系统及抗胆碱能不良反应少。结论舍曲林尤适用于难治性强迫症。     

Escitalopram versus sertraline in the treatment of major depressive disorder: a randomized clinical trial*

ABSTRACT

Objective: This trial was conducted to compare the efficacy and tolerability of a fixed dose of escitalopram 10?mg/day with sertraline optimally dosed within its recommended dose range (50–200?mg/day) for the treatment of major depressive disorder.

Methods: In this multicenter trial, depressed patients (DSM?IV defined; baseline Montgomery–Asberg Depression Rating Scale [MADRS] ≥ 22) aged 18–80 years were randomly assigned to 8 weeks of double-blind treatment with escitalopram (10?mg/day) or sertraline (50–200?mg/day) following a 1?week single-blind placebo lead-in period. There was no placebo comparison arm. Sertraline was initiated at 50?mg/day, and could be increased by 50?mg/day at weekly intervals based on clinical need and tolerability at the lower dose level. The blind was maintained with matching double-blind placebo capsules for the escitalopram group. Change from baseline to endpoint in MADRS total score (last observation carried forward) was the primary efficacy measure.

Results: A total of 212 patients received double-blind medication. At week 8, the mean sertraline dosage was 144?mg/day (median = 150?mg/day). Mean changes from baseline to endpoint in MADRS scores were –19.1 and –18.4 for the escitalopram and sertraline groups, respectively. At endpoint, 75% and 70% of escitalopram- and sertraline-treated patients, respectively, were responders (≥ 50% improvement from baseline in mean MADRS scores). Both treatments were generally well tolerated; only 2% and 4% of patients prematurely discontinued escitalopram and sertraline treatment, respectively, due to adverse events.

Conclusion: No differences in efficacy were observed for fixed-dose escitalopram 10?mg/day and sertraline flexibly dosed from 50–200?mg/day. At these doses, both escitalopram and sertraline were generally well tolerated.     

舍曲林和氯丙咪嗪治疗68例惊恐障碍的疗效比较

目的评价舍曲林治疗惊恐障碍的疗效和安全性。方法采用随机单盲病例对照研究,为期24周．以临床判断和PASS、HAMD、HAMA量表来评定临床效果,以TESS来评定药物不良反应。结果入组68例舍曲林组36例,氧丙味嗪组32例）．舍曲林组最高剂量平均132．5±25．25mg·d^-1。氯丙咪嗪组为153．62mg·d^-1．临床疗效。第四周末舍曲林有效率为77．7％,氯丙咪嗪组为65．6％．两组有统计学盖异（P〈0．05）,而二十四周末两组的有效率分别为100％和96．9％,两组无明显差异。从PASS、HAMD、HAMA量表来看舍曲林组从第二周末开培有明显下降,而氯丙咪嗪组则在第三或第四周以后才开始明显改变。从副反应来看舍曲林组总的发生率13．61%。明显低于氛丙味嗪组的24．68％。结论舍曲林治疗惊恐障碍和氯丙咪嗪比较具有起效快,疗效好。副作用小等特点。是一种安全有效的治疗惊恐障碍药物。     

A placebo-controlled study of sertraline in the treatment of outpatients with seasonal affective disorder

Rationale Seasonal affective disorder (SAD) is a relatively common cyclical depressive illness characterized by seasonal depressions during winter. The disorder is commonly responsive to light therapy, but antidepressant drug efficacy has not been definitely established. Serotonin selective re-uptake inhibitors are potentially efficacious treatments for SAD.Objectives The objective of this study was to evaluate the efficacy, tolerability and safety of sertraline treatment for SAD.Methods One hundred and eighty seven outpatients with seasonal pattern recurrent winter depression (DSM-III-R defined) and a minimum 29-item Hamilton depression scale (SIGH-SAD version) score of 22 were randomized to 8 weeks treatment with either sertraline or placebo in a double-blind, multi-country, multi-center, parallel-group, flexible dose (50–200 mg once daily) study. Efficacy was investigated using physician and patient-rated scales measuring depression, anxiety and symptoms characteristic of seasonal affective disorder.Results Sertraline produced a significantly greater response than placebo at endpoint as measured by changes in the 29-item and 21-item Hamilton depression scales, the clinical global impression (CGI) severity scale, the Hamilton anxiety scale, and the hospital anxiety and depression scale. The proportion of sertraline-treated subjects achieving a response on the CGI improvement rating (ratings of 1 or 2) at endpoint (last observation carried forward) was significantly greater than that of the placebo group. Overall sertraline was well tolerated with the most frequent placebo adjusted adverse events, being nausea, diarrhea, insomnia and dry mouth. Adverse events were mostly mild to moderate and transient.Conclusions Sertraline pharmacotherapy has been demonstrated to be an effective and well-tolerated therapy for out patients with SAD. As such, sertraline offers an important pharmacological option in the clinical management of this condition.The authors wrote this article on behalf of the International Collaborative Group on Sertraline in the Treatment of Outpatients with Seasonal Affective Disorder.Preliminary results from this study were presented previously at the 148th meeting of the American Psychiatric Association, Miami, Florida, 24 May 1995     

The serotonin transporter polymorphism, 5HTTLPR,is associated with a faster response time to sertraline in an elderly population with major depressive disorder

Rationale A common polymorphism (5HTTLPR) within the promoter region of the serotonin transporter gene (LSC6A4) has been shown to influence response time as well as overall response to selective serotonin reuptake inhibitors (SSRIs) in subjects with major depressive disorder. We hypothesized that a similar effect in response time to sertraline would be observed and that no effect on response time would be seen in a placebo arm.Objectives We tested the hypothesis that subjects homozygous for the long allele at the 5HTTLPR polymorphism would respond more rapidly to sertraline than subjects carrying one or two copies of the short allele.Methods HAM-D and CGI-I responses to sertraline and placebo were measured weekly in the context of an 8-week, placebo-controlled study in elderly depressed subjects. Genotyping of the 5HTTLPR polymorphism was performed to test for correlations with response at each week in the sertraline and placebo groups (n=206).Results Subjects homozygous for the long allele of 5HTTLPR showed a significant increase in response at week 1 and week 2, as assessed by the CGI-I scale compared with subjects carrying one or two copies of the short allele (P=0.01 at both weeks). No significant difference was observed in the placebo group.Conclusions These results suggest that genetic variation in the serotonin transporter gene effects the response time to sertraline and provides complementing evidence to previous reports that this polymorphism affects response time to other SSRIs.     

A comparative,randomized, double-blind study of trazodone prolonged-release and sertraline in the treatment of major depressive disorder

ABSTRACT

Objectives: To evaluate the efficacy and safety of trazodone prolonged-release compared with sertraline in the treatment of patients with major depression.

Research design and methods: A total of 122 patients aged 19–64 years were enrolled in this multicenter, double-blind, double-dummy, randomized, comparator-controlled study. Patients received 7 days of single-blind placebo treatment followed by 6 weeks of double-blind treatment with trazodone prolonged-release 150–450?mg/day (n = 62) or sertraline 50–100?mg/day (n = 60).

Outcome measures: Efficacy was evaluated by mean changes from baseline in the Hamilton Depression Rating scale (HAM‐D), Montgomery Asberg Depression Rating Scale, Hamilton Anxiety Rating scale, and the Clinical Global Impression-Global Improvement/Severity scores; and by the rates of patients responding to treatment and considered to be in remission. Time to onset of efficacy and safety were assessed.

Results: Trazodone and sertraline were equally effective in reducing depressive symptoms and promoting remission, and had similar onset times. In the Intent-to-Treat population, there were no significant differences in favor of trazodone at study endpoint in all efficacy measures, while a statistically significant difference was detected in the Per-Protocol population on HAM‐D and in the percentage of responders. Analysis of HAM‐D factors (anxiety/somatization, cognitive disturbance, retardation, and sleep disturbance) indicated that sleep disturbances were significantly less evident for patients taking trazodone at study endpoint. Adverse drug reactions, mostly of mild intensity, were reported in 42% of trazodone-treated patients (mainly of the nervous system) and 43% of sertraline-treated patients (mainly gastrointestinal). One event was considered to be serious: a patient treated with trazodone 450?mg/day showed moderate anxiety/tremor/insomnia and was hospitalized. Treatment was discontinued; the patient made a full recovery.

Conclusions: This study showed that after 6 weeks, trazodone and sertraline were not different in reducing symptoms of depression and in producing disease remission. Tolerability profiles reflected the differing pharmacological properties of these antidepressants. Trazodone may be a therapeutic option in the treatment of patients with major depression showing prevalent sleep disturbances.     

舍曲林联合行为疗法治疗强迫症的随机对照研究

目的研究舍曲林联合行为疗法治疗强迫症的临床疗效。方法将门诊与住院的强迫症患者37例随机分为舍曲林单一药物治疗组与舍曲林合并行为治疗的综合治疗组。全部患者在人组时和治疗12周时用耶鲁一布朗量表进行强迫症状严重程度评定。结果综合治疗组在12周时耶鲁一布朗量表评分显著低于单一舍曲林用药组，舍曲林联合行为疗法治疗强迫症有效，且临床疗效显著优于单一舍曲林用药。结论与舍曲林单一用药治疗相比．舍曲林联合行为疗法治疗强迫症的疗效更明显。     

盐酸舍曲林片在稳定期慢性阻塞性肺疾病合并抑郁症的临床应用

目的:探讨盐酸舍曲林片对抑郁的稳定期慢性阻塞性肺疾病患者的影响。方法:将120例抑郁的稳定期慢性阻塞性肺疾病患者随机分为常规组和实验组,常规组仅实施常规的治疗,实验组除给予常规的治疗,还给予盐酸舍曲林片口服,抗抑郁治疗,5周后评价患者的肺功能及抑郁状态。结果:实验组和常规组比较,患者肺功能指标改善,HAMD评分亦显著低于常规组(P<0.05)。结论:盐酸舍曲林片能改善慢性阻塞性肺疾病患者的肺功能及抑郁情绪。     

研究舍曲林与喹硫平治疗强迫症患者的临床效果

目的 分析舍曲林与喹硫平治疗强迫症患者的临床效果.方法 100例强迫症患者,根据随机数字表法分为对照组与研究组,各50例.对照组采用舍曲林治疗,研究组采用舍曲林+喹硫平治疗.对比两组治疗前后耶鲁-布朗强迫症状量表(Y-BOCS)评分、汉密尔顿焦虑量表(HAMA)评分及疗效.结果 治疗后,研究组的Y-BOCS评分(7.0...