艾司西酞普兰治疗糖尿病患者焦虑抑郁状况

目的 评价艾司西酞普兰治疗糖尿病患者焦虑抑郁的效果和对血糖的影响.方法 对72例符合糖尿病诊断标准且伴焦虑、抑郁者,进行6周的随机对照研究,被试分为研究组和对照组各36例.对照组在常规的糖尿病治疗基础上,给予单纯的心理治疗；研究组在上述基础上,给予艾司西酞普兰5～20mg/d,采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)进行疗效评定,用副反应量表(TESS)评定不良反应.糖化血红蛋白(GHb)用于血糖控制的监测.结果 ①研究组治疗前后HAMD及HAMA评分比较有显著性差异(t=4.85,5.69;P＜0.01)；②两组间从治疗第2周末起,各时点HAMD及HAMA评分有显著性差异(t=4.67,5.01；P＜0.01)、TESS评分无显著性差异(t=3.68,P＞0.05)；③研究组GHb水平改善优于对照组,但无显著性差异.结论 艾司西酞普兰能有效缓解糖尿病患者的抑郁、焦虑症状,有利于血糖的控制,药物相互作用少,耐受性好,安全性高,起效快.

The Effect of Escitalopram on Depression and Anxiety of Diabetic Patients

Objective To evaluate the effect of escitalopram on anxiety,depression and blood sugar of diabetic patients.Methods A total of 72 diabetic patients with anxiety and depression were divided into two groups of 36 patients each.The control group in the conventional treatment of diabetes mellitus was offered pure psychological treatment;Study group on the basis of the above,administration of escitalopram 5 ～20 mg/ day,using HAMD and HAMA to assess therapeutic effect,using TESS scale to assess adverse reactions.Glycosylated hemoglobin（GHb）was used to monitor blood glucose.Results ①There were significant differences of HAMD and HAMA scores（t=4.85,5.69;P0.01）in study group between before and after treatment;②There were significant differences of HAMD and HAMA scores between two groups from the treatment of second weekend（t=4.67,5.01;P0.01）,and no significant difference in the score of TESS（t=3.68,P0.05）;③ There was no significant difference in improvement of GHb level between two groups.Conclusion Escitalopram can effectively relieve the depression,anxiety symptoms of diabetic patients,which is good to glycemic control,and less drug interactions,good tolerance,high safety,fast acting.