阿戈美拉汀与帕罗西汀治疗伴抑郁障碍Ⅱ型糖尿病临床研究

目的探讨阿戈美拉汀与帕罗西汀治疗伴抑郁障碍Ⅱ型糖尿病的临床效果.方法将116例伴抑郁障碍的Ⅱ型糖尿病患者按照服用抗抑郁药物不同分为A组40例、B组39例、C组37例,A组采用糖尿病药物予以常规治疗,B组在A组基础上口服帕罗西汀治疗,C组在A组基础上口服阿戈美拉汀治疗,观察12周.治疗前后检测3组空腹血糖、糖化血红蛋白、体质量指数变化,采用汉密顿焦虑量表评定焦虑状况,汉密顿抑郁量表评定抑郁状况,随对记录治疗期间出现的各种不良反应,统计患者的治疗满意度.结果治疗后3组糖化血红蛋白、空腹血糖水平、体质量指数、焦虑自评量表及抑郁自评量表评分均较治疗前显著下降(P<0.05或0.01),其中降低幅度C组>B组>A组,差异均有统计学意义(P<0.05);治疗期间3组各种单项不良反应发生率比较差异均无统计学意义(P>0.05),但B组总体不良反应发生率显著高于A组、C组(P<0.05);治疗后C组满意度显著高于A组、B组,B组显著高于A组(P<0.05).结论对Ⅱ型糖尿病伴抑郁障碍患者在糖尿病常规治疗的基础上联合应用阿戈美拉汀、帕罗西汀治疗均能提升血糖控制水平,改善焦虑、抑郁情绪,安全性高,但联合阿戈美拉汀控制效果优于帕罗西汀.

Clinical study of agomelatine and paroxetine in the treatment of type 2 diabetes with depression

Objective To investigate the effect of agomelatine and paroxetine in the treatment of type 2 diabetes with depression.Methods 116 patients with type 2 diabetes mellitus with depression were divided into group A(40 cases),group B(39 cases),group C(37 cases)according to different antidepressants.Patients in group A were treated with conventional diabetes.In group B,patients were treated with paroxetine based on group A treatment.In group C,patients were given agomelatine on the basis of group A treatment.Changes in fasting blood glucose,glycated hemoglobin,and body mass index were measured before and after treatment in the three groups.The anxiety status was assessed using the Hamilton Anxiety Scale,and the depression status was assessed using the Hamilton Depression Scale.Various adverse reactions that occurred during treatment were recorded at any time,and the patient's treatment satisfaction was counted.Results After treatment,the glycosylated hemoglobin,fasting blood glucose,BMI,depression and anxiety scores of the three groups were all reduced(P<0.01).The reduction range was C group>B group>A group,the differences were statistically significant(P<0.05 or 0.01).The data of individual adverse reactions in the three groups were not statistically significant(P>0.05).However,the overall incidence of adverse reactions in group B was significantly higher than those in groups A andC(P<0.05).Satisfaction after treatment in group C was significantly higher than those in groups A and B,and group B was significantly higher than that in group A(P<0.05).Conclusions The combination of agomelatine and paroxetine treatment for patients with typeⅡdiabetes with depression based on conventional diabetes treatment can improve blood glucose control,improve anxiety,depression,and has high safety.The combined effect of agomelatine is better than paroxetine.