氟西汀联合喹硫平治疗脑卒中后抑郁症对照研究

目的 探讨氟西汀联合小剂量喹硫平治疗脑卒中后抑郁的临床疗效和安全性.方法 将70例脑卒中后抑郁症患者随机分为两组,每组35例,两组均进行神经内科常规治疗及康复治疗,均口服氟西汀治疗,研究组联合喹硫平治疗,观察8周.于治疗前及治疗后第1周、2周、4周、6周、8周末采用汉密顿抑郁量表和副反应量表评定临床疗效和不良反应.结果 治疗后两组汉密顿抑郁量表评分均较治疗前有显著下降,研究组治疗1周、2周、4周、6周末较对照组下降更显著(P＜0.01),8周末与对照组差异无显著性(P＞0.05);治疗8周末研究组显效率85.71%、总有效率94.29%,对照组分别为54.28%、80.00%,研究组显效率显著高于对照组(χ2=8.23,P＜0.01),总有效率差异无显著性(χ2=3.19,P＞0.05);两组不良反应均较轻微.结论 氟西汀联合小剂量喹硫平治疗脑卒中后抑郁起效快,疗效好,安全性高,依从性好,显著优于单用氟西汀治疗.

A control study of fluoxetine plus quetiapine in the treatment of poststroke depression

Objective To explore the clinical efficacy and effects of fluoxetine plus small dose quetiapine in the treatment of poststroke depression （PD）. Methods Seventy PD patients were randomly divided into two groups of 35 ones each, both groups received neurological conventional and convalescent treatment and oral fluoxetine, research group was plus plus quetiapine for 8weeks. Clinical efficaeies were assessed with the Hamilton Depression Scale （HAND） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1^st, 2^nd, 4^th, 6^th and 8^th week. Results After treatment the HAMD scores lowered more significantly compared with pretreatment in both groups, so did in the research than in the control group at the end of the 1^st , 2^nd , 4^th and 6^th week （P〈0.01）, and there was no significant difference at the end of the 8th week （P〉0.05） ; at the end of the 8th week, there was signifi- cant differences in obvious effective rate （research 85.71% vs. control 54.28%, X^2=8.23, P〈0.01） and no in total effective rate （94. 29% vs. 80. 0%, X^2 = 3. 19, P〉0. 05）; adverse reactions of both groups were mild. Conclusion Fluoxetine plus small dose quetiapine takes effect more rapidly and has better efficacy,higher safety and better compliance compared with fluoxetine only in the treatment of poststroke depression.