盐酸舍曲林治疗脊髓亚急性联合变性伴焦虑抑郁障碍的临床观察

目的 观察盐酸舍曲林治疗脊髓亚急性联合变性(SCD)合并焦虑抑郁患者的临床疗效.方法 选取2011年3月至2016年3月间解放军总医院第一附属医院干部病房收治的伴有抑郁焦虑的SCD患者55例,按其治疗方式分为观察组28例和对照组27例,对照组仅给予常规治疗,观察组在常规治疗基础上给予盐酸舍曲林治疗,连续治疗6个月.治疗后1、3、6个月分别进行汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)评分,测量患者体感诱发电位,并对两组患者的疗效进行评价.结果 治疗后1个月和3个月,观察组患者的治疗总有效率高于对照组(53.57%vs 25.93%,92.86%vs 62.96%),差异均有统计学意义(P<0.05);治疗后3个月,观察组与对照组患者的N13潜伏期(13.2±1.2)ms vs(14.1±1.5)ms]、N20潜伏期(20.4±1.9)ms vs(21.2±1.9)ms]、P40潜伏期(40.5±2.0)ms vs(42.1±2.1)ms]比较均有明显下降,差异均有统计学意义(P<0.05);治疗后1、3、6个月,观察组的HAMA评分(17.1±4.4)分、(10.5±3.7)分、(8.4±4.9)分]和HAMD评分(17.2±4.2)分、(9.2±4.4)分、(7.9±5.2)分]均明显低于对照组的HAMA评分(19.2±5.1)分、(17.3±4.6)分、(16.1±4.6)分]和HAMD评分(19.7±5.3)分、(16.2±4.7)分、(15.3±5.6)分],差异均有统计学意义(P<0.05);观察组的症状消失时间为(63.3±10.5)d,明显优于对照组的(87.2±9.1)d,差异有统计学意义(P<0.05).结论 盐酸舍曲林不仅能改善SCD合并焦虑抑郁患者的情绪障碍,还能改善患者的感觉运动功能,疗效明显优于传统治疗.

Clinical efficacy of sertraline hydrochloride in the treatment of patients with subacute combined degeneration of spinal cord accompanied by anxiety and depression

Objective To explore the clinical efficacy of sertraline hydrochloride in the treatment of patients with subacute combined degeneration (SCD) accompanied by anxiety and depression. Methods From March 2011 to March 2016, 55 SCD patients with anxiety and depression admitted to Cadre Ward of the First Affiliated Hospital of Gen-eral Hospital of Chinese PLA were divided into control group (n=27) and observation group (n=28) according to the way of treatment. Patients in control group were treated with routine therapy, and those in observation group were treated with routine therapy plus sertraline hydrochloride, both for 6 months. One, three, six months after treatment, all patients were evaluated by Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD), and somatosensory evoked potential was measured. The clinical efficacy of two groups were observed and compared. Results One, three months after treatment, the total effective rate in observation group (53.57%, 92.86%) was significantly higher than those (25.93%, 62.96%) in control group (P<0.05). Three months after treatment, N13 latency, N20 latency and P40 latency were (13.2±1.2) ms, (20.4±1.9) ms, (40.5±2.0) ms in observation group, significantly lower than (14.1±1.5) ms, (21.2± 1.9) ms, (42.1 ± 2.1) ms in control group (P<0.05). One, three, six months after treatment, scores of HAMA (17.1 ± 4.4, 10.5±3.7, 8.4±4.9) and HAMD (17.2±4.2, 9.2±4.4, 7.9±5.2) in observation group were significantly lower than those of HAMA (19.2±5.1, 17.3±4.6, 16.1±4.6) and HAMD (19.7±5.3, 16.2±4.7, 15.3±5.6) in control group (P<0.05). Symptom disappearance time of observation group was shorter than that of control group, (63.3 ± 10.5) d vs (87.2 ± 9.1) d, P<0.05. Conclusion SCD For patients with anxiety and depression, application of sertraline hydrochloride can improve the anxi-ety and depression symptoms and sensory motor function, and results in superior efficacy, compared with routine therapy.