盐酸舍曲林联合阿戈美拉汀治疗抑郁症伴失眠的效果以及对血清氧化应激因子水平的影响

目的观察盐酸舍曲林联合阿戈美拉汀治疗抑郁症伴失眠的效果,以及对血清超氧化物歧化酶(SOD)和丙二醛(MDA)水平的影响。方法筛选抑郁症伴失眠患者98例,按随机数字表法分为对照组和观察组,各49例。对照组给予盐酸舍曲林片50 mg,po,qd;观察组在对照组基础上给予阿戈美拉汀片(起始剂量为25 mg·d^-1,po;2周后若疗效欠佳则加量至50 mg·d^-1)。2组患者均连续治疗6周。比较2组患者汉密尔顿抑郁量表(HAMD)-17评分、抑郁自评量表(SDS)评分、匹茨堡睡眠质量指数(PSQI)评分、临床疗效以及血清SOD和MDA水平,并记录2组不良反应发生情况。结果治疗6周后,观察组患者HAMD-17、SDS和PSQI指标(入睡时间、睡眠效率、睡眠时间、睡眠障碍和日间功能)评分均明显低于对照组(P<0.01);观察组总有效率明显高于对照组(95.59%vs 79.59%,P<0.05);观察组患者血清MDA水平明显低于对照组,SOD显著高于对照组(P<0.01)。2组患者不良反应发生率差异无统计学意义(P>0.05)。结论盐酸舍曲林联合阿戈美拉汀治疗抑郁症伴失眠,可明显改善患者的抑郁和失眠症状,提高临床疗效,改善氧化应激水平可能是其疗效途径之一,且安全性好。

Efficacy of sertraline hydrochloride combined with agomelatine in treating depression with insomnia and its effect on serum levels of oxidative stress factors

AIM To investigate the efficacy of sertraline hydrochloride combined with agomelatine in the treatment of depression with insomnia,and its effect on serum levels of superoxide dismutase(SOD)and malondial-dehyde(MDA).METHODS A total of 98 depression patients with insomnia were selected and randomly divided into the control group(49 patients)and the observation group(49 patients)according to the random number table method.The control group was given with sertraline hydrochloride tablets(50 mg,qd).On the basis of the control group,the observation group was given with agomelatine tablets(initial dose for 25 mg·d^-1,po,and dose for 50 mg·d^-1 as poor curative effect after 2 weeks).Both groups were treated for 6 weeks.The Hamilton depression scale(HAMD)-17 score,self-rating depression scale(SDS),Pittsburgh sleep quality index(PSQI),the efficacy,and serum levels of SOD and MDA were compared between the 2 groups.Adverse drug reactions of the 2 groups were recorded.RESULTS After 6 months'treatment,scores of HAMD-17,SDS and PSQI(a sleep latency,sleep efficiency,sleep time,sleep disorders and daytime function)in the observation group were significantly lower than those in the control group(P<0.01).The total effective rate of the observation group was 95.59%,which was sig-nificantly higher than that of the control group(79.59%)(P<0.05).Serum level of MDA in the observation group was significantly lower than that in the control group,while SOD level in the observation group was significantly higher than that in the control group(P<0.01).There was no significant difference in the incidence of adverse drug reactions between the 2 groups(P>0.05).CONCLUSION The combination of sertraline hydrochloride and agomelatine in the treatment of depression with insomnia can significantly improve the symptoms of depression and insomnia,and increase the efficacy.Improving the level of oxidative stress may be one of the therapeutic approa-ches,and has high safety.