氟西汀与阿米替林双盲对照治疗抑郁障碍病人16例

目的：评价国产氟西汀治疗抑郁障碍的疗效和副作用。方法：采用国产氟西汀和阿米替林双盲对照治疗１６例抑郁障碍病人。氟西汀组８例（男性３例，女性５例，年龄４５±ｓ１４ａ），用氟西汀２０ｍｇ，ｐｏ，ｑｄ。阿米替林组８例（男性３例，女性５例，年龄４４±１３ａ），用阿米替林７５ｍｇ，ｐｏ，ｂｉｄ。疗程６ｗｋ。结果：治疗后２组病人的ＨＡＭＤ，ＨＡＭＡ，ＳＤＳ评分均显著下降，显效率均为１００％，２种药物在疗效和副作用方面未有显著差异。结论：国产氟西汀是满意的新型抗抑郁剂。     

Interstitial cystitis: bladder pain and beyond

Background: Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of a urinary tract infection. Interstitial cystitis occurs primarily in females including adolescents and its diagnosis is still one of exclusion. It is now recognized as a serious medical condition associated with significant disability. Objective: The aim of this paper was to review the pathogenesis and treatment of interstitial cystitis with emphasis on new pathogenetic trends and therapeutic modalities. Methods: About 713 mostly original papers were reviewed in Medline from 1990 to August. 2008. All authors independently reviewed the literature. Large, double-blind, placebo-controlled, clinical trials were few and the medical histories of the patients used varied considerably making conclusions difficult. Promising pilot trials turned out mostly negative on follow-up. Results: Increasing evidence of co-morbid diseases, neurogenic inflammation and the effect of stress are promising as new targets for pathophysiology. No new effective treatments have emerged. Oral pentosanpolysulfate, amitriptyline, hydroxyzine and quercetin, as well as intravesical heparin/bicarbonate/lidocaine solutions, are still used with variable success. Some pilot open-label trials presented encouraging findings. Conclusion: Interstitial cystitis contributes substantially to chronic pelvic pain and to poor quality of life. Oral or intravesical administration of solutions containing sodium hyaluronate, chondroitin sulfate and quercetin to both reduce bladder inflammation and ‘replenish’ the glycosaminoglycan layer should be tried. There is a clear need for therapeutic modalities. New potential translational research areas are suggested.     

Daledalin Tosylate: A Controlled Trial in Depressive Illness

Summary

Pharmacological studies of a novel chemical - daledalin tosylate (UK 3557), an indoline compound - suggested the possibility of antidepressant activity with fewer autonomic side-effects in man. A double-blind comparison of daledalin tosylate and amitriptyline hydrochloride as a standard reference antidepressant was carried out in 28 patients with depressive illnesses. Sixteen patients received daledalin tosylate and 12 amitriptyline hydrochloride. The concept of ‘depressive illness’ and the criteria for inclusion in the study are discussed at length.

No statistically significant differences between the two drugs could be found in the Hamilton Rating Scale for Depression, the Wakefield Self-Assessment Depression Scale, global assessment of severity of illness or change in condition, side-effects check list, or the trend analysis of the laboratory results by linear regression.

It was concluded that daledalin tosylate had antidepressant effects comparable with amitriptyline but no clinical advantages over the latter.     

Epinephrine potentiates the analgesic and antidepressant effects of amitriptyline as a result of stimulation of the gastric mucosal afferents

Intramuscular amitriptyline in the minimum effective dose causes maximum analgesic and antidepressant effect and significant sedation in rats. Combined injection of amitriptyline with epinephrine in the threshold doses (ineffective if used alone), 1/10 and 1/30 minimum effective doses, respectively, leads to the development of the maximum analgesic and antidepressant effect, but causes no sedative side effect. This potentiation is mediated by stimulation of afferents in the gastric mucosa with epinephrine. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 144, No. 11, pp. 535–537, November, 2007     

国产米氮平与阿米替林治疗抑郁障碍对照研究

目的 探讨国产米氮平与阿米替林治疗抑郁障碍的临床疗效和安全性.方法 将64例抑郁障碍患者随机分为两组,每组32例,研究组口服国产米氮平治疗,对照组口服阿米替林治疗,观察6周.于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应.依据汉密顿抑郁量表评分统计两组治疗前后抑郁症状检出率,同时评估两组患者服药依从性.结果 治疗后两组汉密顿抑郁量表评分均较治疗前呈持续性显著下降(P＜0.01),减分率呈持续性升高.研究组治疗1周末、2周末汉密顿抑郁量表评分较对照组下降更显著,减分率较对照组升高更显著(P＜0.05).治疗6周末除对照组自责、自杀念头症状检出率与治疗前差异无显著性外(P＞0.05),两组各种抑郁症状检出率均显著低于治疗前(P＜0.01);研究组兴趣丧失、自责、自杀念头症状检出率均显著低于对照组(P＜0.01),其他症状检出率差异均无显著性(P＞0.05).研究组不良反应发生率为21.9%,对照组为46.9%,研究组显著低于对照组(χ2=4.43,P＜0.05);服药依从性显著高于对照组(P＜0.01).结论 国产米氮平治疗抑郁障碍疗效显著,与阿米替林相当,但起效更快,安全性更高,依从性更好,优于阿米替林治疗.     

星状神经节阻滞与阿米替林治疗早泄对照研究

目的比较星状神经节阻滞与阿米替林治疗早泄的疗效及安全性。方法将60例早泄患者随机分为两组各30例,研究组用星状神经节阻滞治疗,隔日1次,7次为1疗程。对照组性交前1h口服阿米替林治疗12.5mg·d-1,15d为1疗程。比较两组疗效及安全性。结果两组治疗后早泄较治疗前均有极显著性改善(P<0.01),但研究组比对照组改善更显著,两组差异有极显著性(P<0.01)。结论星状神经节阻滞治疗早泄治愈率高,起效时间快,不良反应轻,复发率低。     

阿米替林对局灶性脑缺血/再灌注损伤脑内单胺类神经递质的影响

目的研究阿米替林对大鼠局灶性脑缺血/再灌注损伤的作用。方法用线栓法建立大鼠局灶性脑缺血/再灌注损伤模型,用TTC染色和图像分析系统测梗死体积;神经功能缺损采用0～5级评分;荧光分光光度法测定大脑皮层和纹状体多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)及5-羟吲哚乙酸(5-HIAA)。观察阿米替林对大鼠局灶性脑缺血1h/再灌注2h时脑梗死体积、神经功能及大脑皮层和纹状体单胺类神经递质的影响。结果缺血1h/再灌注2h时,阿米替林可使脑梗死体积变小、神经功能缺损评分分值明显降低、单胺递质含量明显提高,与模型组相比差异有显著性。结论阿米替林对大鼠局灶性脑缺血/再灌注引起的神经损伤有保护作用。其机制可能与其减少缺血/再灌注期间单胺类神经递质的释放有关。     

西酞普兰与阿米替林治疗老年抑郁症临床对照研究

目的探讨西酞普兰治疗老年抑郁症的临床疗效及安全性。方法将62例老年抑郁患者随机分配至西酞普兰与阿米替林组（各31例），西酞普兰治疗剂量为10-40mg／d，1次／d，阿米替林150—300mg／d，1／d，观察期为6周，疗效评定采用HAMD，安全性评价用TESS、实验室检查及查体。结果两组治疗后HAMD评分均显著下降，两组间比较差异无显著性（P〉0．05）。良反应发生率西普酞兰组显著低于阿米替林组（P〈0．05）。结论两药疗效相当，但西酞普兰副反应少且轻，日服量小，服药方便。