帕罗西汀/黛力新联合治疗脑梗塞恢复早期抑郁的临床观察

[目的]观察帕罗西汀/黛力新联合治疗脑梗塞恢复早期抑郁疗效。[方法]将102例脑梗塞恢复早期抑郁患者分为帕罗西汀组、黛力新组和帕罗西汀/黛力新组,每组均为34例,8周为1疗程,随访半年。观察用药前后汉密尔顿抑郁(HAMD)量表评分、Barthel指数及不良反应情况。[结果]帕罗西汀/黛力新组在2周内见效,在2～6周随治疗时间推移而更加显效(P﹤0.01),在6～8周疗效无明显变化(P﹥0.05),疗效优于黛力新组和帕罗西汀组。随访6个月帕罗西汀/黛力新组复发率少于黛力新组和帕罗西汀治疗组(P﹤0.05)。3组不良反应均较少,差异无统计学意义(P﹥0.05)。[结论]帕罗西汀/黛力新联合治疗脑梗塞恢复早期抑郁快速、有效、安全,是一种值得应用的治疗方法。     

草酸艾司西酞普兰与帕罗西汀治疗惊恐障碍的比较

目的探讨草酸艾司西酞普兰对惊恐障碍患者的疗效及副作用。方法对38例惊恐障碍患者随机分为草酸艾司西酞普兰组和帕罗西汀组,疗程8周,并用汉密尔顿焦虑量表（HAMA）,抗抑郁药不良反应评定检验量表（SERS）,对患者治疗前后进行评估。结果在治疗第1、2、4、6、8周末两组患者的HAMA分值差异无显著性意义,在治疗第8周末时,草酸艾司西酞普兰组治愈率为63．2％,有效率为89．5％,帕罗西汀组治愈率为64．7％,有效率为88．2％。两组无显著性差异。在副反应方面,草酸艾司西酞普兰组各种不良反应发生率较帕罗西汀组低,且轻微。结论草酸艾司西酞普兰治疗惊恐障碍疗效与帕罗西汀相当,不良反应少且轻微。     

低频重复经颅磁刺激联合帕罗西汀治疗抑郁症的疗效及安全性分析

目的观察低频重复经颅磁刺激(r TMS)联合帕罗西汀治疗抑郁症的疗效及安全性。方法将64例抑郁症患者随机分为研究组和对照组,每组各32例。采用汉密尔顿抑郁量表(HAMD17)、汉密尔顿焦虑量表(HAMA)和治疗中出现的症状量表(TESS)分别评定两组患者的疗效和不良反应。结果经6周治疗后,两组的治疗有效率分别为87.5%和65.7%,差异有统计学意义(P0.05);从治疗第1周开始,研究组患者HAMD和HAMA评分下降较对照组显著(P均0.05)。结论与单用帕罗西汀比较,rTMS联合帕罗西汀治疗抑郁症起效较快、疗效好,不良反应少,值得临床上推广应用。     

肉蔻五味丸联合盐酸帕罗西汀治疗广泛性焦虑症临床研究

目的探讨肉蔻五味丸联合盐酸帕罗西汀治疗广泛性焦虑症的临床疗效和安全性。方法将60例广泛性焦虑症患者随机分为对照组和观察组,对照组采用盐酸帕罗西汀治疗,观察组在对照组基础上加肉蔻五味丸治疗。结果对照组总有效率为83.33%,观察组总有效率为93.33%。两组患者治疗后汉密尔顿焦虑量表(Hamilton anxietyscale,HAMA)、焦虑自评量表(self-rating anxiety scale,SAS)评分均较治疗前明显下降(均P<0.05),治疗1、2、4、8、12周末两组患者HAMA、SAS评分比较差异均有统计学意义(均P<0.05)。结论肉蔻五味丸联合盐酸帕罗西汀治疗广泛性焦虑症具有较好的临床疗效,安全性高,值得临床推广应用。     

米氮平片联合盐酸帕罗西汀片在老年高血压病合并抑郁症患者中的疗效

目的探讨老年高血压病合并抑郁症患者采用米氮平片联合盐酸帕罗西汀片治疗的疗效及对患者负性情绪和睡眠质量的影响。方法选取2020年6月至2021年6月期间温州市第七人民医院收治的110例老年高血压病合并抑郁症患者作为研究对象, 应用随机数字表法将患者分为帕罗西汀组(n=35)、米氮平组(n=35)和联合组(n=40)。3组均在常规降压治疗基础上联合抗抑郁药物治疗, 其中帕罗西汀组联合盐酸帕罗西汀片治疗, 米氮平组联合米氮平片治疗, 联合组联合米氮平片和盐酸帕罗西汀片治疗。比较3组疗效和不良反应发生率;比较3组治疗前后负性情绪和睡眠质量。结果帕罗西汀组与米氮平组疗效比较差异无统计学意义(P>0.05);联合组疗效明显优于帕罗西汀组和米氮平组(均P<0.05)。治疗后, 3组24项汉密尔顿抑郁量表(HAMD24)、汉密尔顿焦虑量表(HAMA)和匹兹堡睡眠质量(PSQI)评分均明显低于治疗前(均P<0.05);联合组上述评分明显低于帕罗西汀组和米氮平组(均P<0.05)。3组不良反应发生率比较差异无统计学意义(P>0.05)。结论米氮平片联合盐酸帕罗西汀片治疗老年高...     

疏肝解郁胶囊联合帕罗西汀治疗脑卒中后抑郁焦虑的疗效观察

目的：观察疏肝解郁胶囊联合帕罗西汀治疗脑卒中后抑郁焦虑的临床效果。方法回顾性分析2012年02月—2013年02月期间在我院治疗的110例脑卒中伴焦虑患者的临床资料,随机将110患者分为观察组（55例）和对照组（55例）,对照组采用常规帕罗西汀治疗;观察组采用舒肝解郁胶囊联合帕罗西汀治疗,治疗前后行汉密尔顿抑郁量表（HAMD）和神经功能缺损评分（SSS）量表进行评定。结果两组患者治疗3个月后,组内治疗前后评分比较,差异均有统计学意义(P＜0.05),组间数据比较,观察组优势明显,差异有统计学意义（P＜0.05）。结论舒肝解郁胶囊联合帕罗西汀治疗脑卒中后抑郁焦虑疗效确切,用药安全、方便,不良反应少,值得临床推广应用。     

盐酸氟西汀合并曲唑酮治疗抑郁症疗效研究

目的观察曲唑酮与氟西汀联合使用对抑郁症的临床疗效。方法随即对68名患者分别使用氟西汀＋曲唑酮和氟西汀单用治疗，使用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）以及药物副反应量表（TESS）评定疗效与不良反应。结果氟西汀＋曲唑酮组在总治疗减分与氟西汀组无显著性差异，但在减分的时间上短于氟西汀组（有显著性差异），HAMA减分优于氟西汀组．不良反应两组无差异。结论氟西汀＋曲唑酮治疗抑郁症起效快且对于伴焦虑症状的抑郁症有良好的疗效。     

喹硫平合并帕罗西汀治疗强迫症临床研究

目的:探讨喹硫平合并帕罗西汀治疗强迫症的临床疗效和安全性.方法:将47例强迫症患者随机分为帕罗西汀组,喹硫平合并帕罗西汀组,随访8周.采用Yale-Brown强迫症量表(Y-Bocs),汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)评定疗效和不良反应.结果:基线时两组间Y-BOCS HAMA评分相似.随访第8周时喹硫平合并帕罗西汀组Y-BOCS评分(12.4±4.7)低于帕罗西汀组(16.1±3.9,t=2.576,P=0.037),HAMA评分(6.9±3.8)也低于帕罗西汀组(10.1±3.6,t=2.236,P=0.017).结论:喹硫平合并帕罗西汀用于强迫症的治疗有明确的疗效和安全性.     

催眠疗法治疗惊恐障碍疗效分析

目的探讨艾瑞克森学派催眠疗法治疗惊恐障碍的疗效。方法对68例确诊的惊恐障碍患者采用催眠疗法。于治疗前后进行汉密尔顿焦虑量表(HAMA)评定及记录每周发作次数,临床疗效以总评分降低≥50%,或惊恐发作频率降低50%两项指标来评定。结果采用催眠疗法治疗惊恐障碍汉密尔顿焦虑量表(HAMA)总评分降低≥50%的有48例,有效率达70.6%,取得相当好的疗效。结论催眠疗法具有不良反应和治疗成本低,疗效好的特点,是临床治疗惊恐障碍的有效手段。     

帕罗西汀片合并经颅微电流刺激疗法治疗焦虑障碍

目的：探讨经颅微电流刺激疗法（CES）对焦虑障碍治疗辅助功效。方法：选取符合CCMD-3焦虑障碍诊断标准并愿意参加本项研究的120例患者,按照随机数字表法分为研究组和对照组,每组60例。除研究组进行6周（共42次）经颅微电流刺激疗法治疗外,两组同时均给予治疗剂量帕罗西汀治疗6周。治疗前后对两组均采用汉密尔顿焦虑量表（HAMA）、临床疗效总评量表-病情严重程度（CGI-SI）评定、WHO生存质量测定简表（WHOQOL-BREF）评定焦虑治疗效果及生活质量改善程度。结果：研究组显效率为76.67%,对照组为53.33%,两组比较差异有统计学意义（P〈0.05）。两组HAMA和CGI-SI评分治疗后均较治疗前显著降低,与治疗前比较差异有统计学意义（P〈0.05）;治疗6周时,研究组HAMA和CGI-SI评分下降较对照组更为显著,两组比较差异均有统计学意义（P〈0.05）。两组治疗后生存质量4个领域项目评分均明显提高,与治疗前比较差异均有统计学意义（P〈0.05）;治疗6周时,研究组生理领域评分增加更为显著,两组比较差异均有统计学意义（P〈0.05）。结论：帕罗西汀合并经颅微电流刺激疗法优于单独应用帕罗西汀治疗焦虑障碍。     

Pharma in the bedroom . . . and the kitchen. . . . The pharmaceuticalisation of daily life

This paper examines the consequences of a new emphasis on lifestyle in the production, marketing and consumption of pharmaceuticals. Over the past decade, a range of medicines have become available that address aspects of lifestyle, while others have been the subject of lifestyle marketing. We argue, with recourse to a broad literature from the social sciences, economics and health services research and from our study of pharmaceutical consumption, that two processes can be discerned. First, there is a domestication of pharmaceutical consumption, with drugs available via home computers, and marketing of pharmaceuticals that focuses upon private or personal conditions and addresses domestic activities such as sex and cooking. Secondly, there is a pharmaceuticalisation of everyday life as the pharmaceutical industry introduces profitable medicines for a range of daily activities and pharmaceuticals come to be seen by consumers as a 'magic bullet' to resolve problems of daily life. We suggest that the pharmaceuticalisation of daily life links the economics and politics of pharmaceutical production to the private lives of citizens.     

Proceedings of the 2014 A.S.P.E.N. Research Workshop

The human and earth microbiomes are among the most important biological agents in understanding and preventing disease. Technology is advancing at a fast pace and allowing for high‐resolution analysis of the composition and function of our microbial partners across regions, space, and time. Bioinformaticists and biostatisticians are developing ever more elegant displays to understand the generated megadatasets. A virtual cyberinfrastructure of search engines to cross‐reference the rapidly developing data is emerging in line with technologic advances. Nutrition science will reap the benefits of this new field, and its role in preserving the earth and the humans who inhabit it will become evidently clear. In this report we highlight some of the topics of an A.S.P.E.N.‐sponsored symposium held during Clinical Nutrition Week in 2013 that address the importance of the human microbiome to human health and disease.     

Violence-related outcomes of the D.A.R.E. plus project.

The objectives of this study were to examine outcomes of the Minnesota D.A.R.E. Plus Project on violence-related behaviors among middle school students and mediation analyses that test how the intervention was effective in reducing physical and verbal violence. Twenty-four schools were randomly assigned to the D.A.R.E. middle school curriculum, the D.A.R.E. Plus multicomponent intervention, or control. The study cohort completed a self-report questionnaire at baseline and two follow-ups. The results showed that boys had higher rates of violence and victimization than girls. The D.A.R.E. Plus program was more effective in preventing violence among boys than among girls. It appears that the small behavioral effect that D.A.R.E. Plus did demonstrate on physical and verbal violence among boys was entirely mediated by a decrease of norms that support violence, an increase in outcome expectancies about being violence-free, and an increase in parental consequences for fighting.     

L.I.F.E. and D.E.A.T.H

In this short, rhetorical article, I offer a thought experiment that seeks to make an analogy between ‘life’ and ‘disease’. This article was written whilst under the influence of Nietzsche, and I hope that readers will not mistake the polemical style and the occasional nod towards humour for flippancy. This is a serious subject, and this article attempts to ask, inexplicitly, a serious question. If we do suspend our subjective value judgements about life, and strip away what might be considered the ‘dogma’ of value in life, what effect might this have on our feelings towards voluntary euthanasia, and what can our reaction to that thought experiment tell us?