产后抑郁症的治疗进展

产后抑郁症是一项严重的公共卫生问题,它能造成妇女自杀和儿童生长发育不良。产后抑郁症妇女基于母乳喂养等考虑,往往对治疗依从性差。本文回顾了目前产后抑郁症的治疗进展,并探讨了各项治疗方案的安全性。     

Sleep deprivation treatment in depression: a review

Ten studies, including the authors'' own, suggest that sleep deprivation may be a useful treatment in a third to a half of patients with endogenous depression. Caution and a controlled trial are suggested.     

Injectable botulinum toxin as a treatment for plantar hyperhidrosis: a case study

Hyperhidrosis is defined as excessive and uncontrollable sweating due to overactivity of the eccrine sweat glands. The first line of treatment for plantar hyperhidrosis consists of conservative therapies such as topical solutions (ie, antiperspirant applications and aluminum chloride preparations) and iontophoresis. When the patient has failed these standard treatments, the other available medical options are rather limited and not well tolerated. Botulinum toxin type A (Botox, Allergan Inc, Irvine, California) is a purified neurotoxin complex approved by the US Food and Drug Administration in 2004 for multiple medical conditions, including severe primary axillary hyperhidrosis that failed conservative topical therapies. Few recent clinical studies have suggested that botulinum toxin is effective in the treatment of plantar hyperhidrosis. In this case study, two patients received intradermal injections of botulinum toxin type A into the plantar aspect of both feet. A 3-month follow-up evaluated the efficacy of botulinum toxin type A by subjectively assessing the amount of residual sweating. In these two patients, botulinum toxin type A was an effective and safe treatment for plantar hyperhidrosis.     

围绝经期抑郁的中药调治

围绝经期抑郁可严重影响女性的身心健康,因雌激素、抗抑郁西药在临床使用时存在诸多禁忌,中医药防治具有明显优势。基于中医学者对本病相关方药的研究,归纳其发病机制及治法,“以法统方”,有利于临床辨证分型的完善。对拟含有雌激素样、抗抑郁作用成分的中药的合理组方及临证加减,可改善患者的抑郁状态和躯体症状。     

黛力新治疗抑郁症的临床研究

目的评价黛力新治疗抑郁症的疗效和不良反应。方法将64例抑郁症患者随机分为黛力新组(33例)和阿米替林组31例,分别给予黛力新和阿米替林治疗,疗程8周。用汉密尔顿抑郁量表(HAM D)、临床疗效总评量表病情严重程度(CG I-S I)和副反应量表(TESS)评定疗效和不良反应。结果黛力新与阿米替林对抑郁症疗效相仿,但前者起效快,不良反应少于后者。结论黛力新是一种安全有效的新型抗抑郁药,具有临床应用价值。     

卒中后抑郁的相关治疗

卒中后抑郁(PSD)是脑卒中后常见的并发症,严重影响卒中患者的神经功能恢复、认知功能的康复及心身健康,降低生活质量,且发病率高、致残率高,自杀风险大,加重了患者家庭及社会负担,故积极有效的治疗尤为重要。该文就目前卒中后抑郁的临床治疗进行了综述。     

阿立哌唑治疗抑郁症的增效作用

目的:探讨艾司西酞普兰联合阿立哌唑治疗抑郁症的疗效和安全性.方法:将60例抑郁症患者随机分为研究组(艾司西酞普兰联合阿立哌唑)30例,对照组(单用艾司西酞普兰)30例.疗程8周.于治疗前和治疗第2、4、8周分别采用汉密尔顿抑郁量表(HAMD)及治疗中出现的症状量表(TESS)评定疗效和不良反应.结果:研究组HAMD量表分于2周显著下降,对照组HAMD量表分于治疗4周显著下降.两组HAMD评分较治疗前均显著下降(P<0.01);两组不良反应差异无统计学意义(P>0.05).结论:艾司西酞普兰联合阿立哌唑治疗抑郁症起效快,疗效确切,不良反应少.     

抑郁症治疗进展的研究

现代生活的快节奏以及精神、心理等方面的压力,使抑郁症的发病率明显提高。据1994年的一项调查显示抑郁症的终身患病率是17．1％,其中男性为13％,女性为21％。世界卫生组织（1993）的一项以15个城市为中心的全球性合作研究,调查综合医院就诊者中的心理障碍,发现患抑郁症障碍的高达12．5％^[1]。然而目前尚没有一种有效的治疗方法能够在疗效、不良反应及预防复发方面尽如人意。本文就抑郁症治疗方面的研究进展作一综述,以期为将来抑郁症的治疗起到指引作用。     

浅论抑郁症烦躁的证治

抑郁症属中医郁证范畴,中医对抑郁症的治疗有着独到的经验与疗效。据有关研究表明,抑郁症患者出现烦躁的频率很高,仅次于情绪低落,某些阶段患者的烦躁症状会尤为明显,甚至出现冲动轻生的可能,严重影响着自身和家人的生活质量。而目前对于此症多从气郁化火与阴虚火旺的角度来论治,鲜有虑及肾阳亏虚与心脾两虚者。     

Strategies for the drug treatment of depression.

Antidepressants are a useful addition to a physician's therapeutic armamentarium, but because they are used to treat disorders of diverse and largely unknown cause, there is a much greater element of chance associated with their use than with the use of many other types of drugs (e.g., antibiotics and analgesics). Nevertheless, empirically derived treatment schemes, applied systematically, increase the odds of a favourable response and are preferred to haphazard prescribing. To date, no one antidepressant has been shown to be more effective than any other, although the newer agents are alleged to be faster acting, more specific and less toxic than the established drugs. However, generally, such claims have not been proven clinically. Unless there are overwhelming contraindications (e.g., intolerable side effects, an idiosyncratic response or coexisting cardiac disease) the established agents, with their proven efficacy, are preferred initially.     

阿立哌唑合并舍曲林治疗难治性抑郁症

目的：探讨阿立哌唑合并舍曲林治疗难治性抑郁症的效果。方法：将68例难治性抑郁症患者随机分成2组,分别给予阿立哌唑合并舍曲林（合用组）与单用舍曲林（单用组）治疗12周,以汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定临床疗效,以不良反应症状量表（TESS）和相关检查评定不良反应。结果：治疗结束时两组HAMD和HAMA的评分均显著降低,以合用组疗效显著而快。结论：阿立哌唑合并舍曲林治疗难治性抑郁症的疗效优于单用舍曲林,且耐受性好。     

Vacuum extraction as a treatment modality of neonatal skull depression in a twin infant

The management of depressed skull fractures in the newborn infant can be controversial. In this article, we report a case of twin pregnancy wherein one of the fetuses had depressed skull fractures that was not associated with any known trauma during the pregnancy or at delivery. This ping-pong skull depression was treated by elevation with an obstetrical vacuum extractor. No complications occurred. The possible etiologies and treatment modalities for neonatal depressed fractures, being conservative or operative, are discussed.     

“清热解郁方”合并氟西汀治疗难治性抑郁症的疗效观察

目的探讨清热养阴解郁方法治疗难治性抑郁症的疗效。方法共55例符合难治性抑郁症诊断标准的患者采用数字表法随机分入氟西汀合并中药治疗组或氟西汀治疗组,疗程12周,进行汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评定。结果与单用氟西汀治疗的患者相比,合并中药治疗能较好地缓解难治性抑郁症患者的焦虑、抑郁症状,治疗第8周,12周末时,2组患者的疗效差异有统计学意义(P<0.05或P<0.01);治疗第4周末时合并服用中药的患者抑郁焦虑情绪即有所缓解(P<0.01)。结论 "清热解郁方"对氟西汀治疗难治性抑郁症患者有增效作用。     

盐酸舍曲林治疗脑卒中后抑郁障碍的临床疗效观察

目的 探讨盐酸舍曲林在脑卒中后抑郁障碍治疗中的临床效果.方法 将我院收治的脑卒中后抑郁障碍患者70例,分别给予脑卒中常规药物治疗(对照组)与脑卒中常规药物联合舍曲林治疗(治疗组),观察2组治疗前后汉密尔顿抑郁量表(HAMD)评分、日常生活能力评定量表即Barthel指数(BI)评分、神经功能缺损(SSS)评分.结果 2组治疗8周后BI评分均增加,SSS评分均减少(P<0.05),治疗组较对照组的变化更显著(P<0.05).治疗组治疗4周、8周后HAMD评分均较治疗前降低,与对照组相比差异有统计学意义(P<0.05).结论 舍曲林治疗脑卒中后抑郁障碍患者疗效确切,值得临床推广.