噻奈普汀联合氟哌噻吨美利曲辛治疗抑郁症方案应用研究

目的观察噻奈普汀联合氟哌噻吨美利曲辛治疗中重度抑郁症的疗效和安全性。方法采用开放随机分组对照研究的方法。将2007年3月至2008年6月360例中重度抑郁症患者按随机数字表法分为噻奈普汀联合氟哌噻吨美利曲辛组（A组）110例，氟西汀联合氟哌噻吨美利曲辛组（B组）95例，单用噻奈普汀组（C组）72例，单用氟西汀组（D组）83例。4组采用相应治疗，分别于1、2、4、6周末采用汉密尔顿抑郁量表（HAMD）评定临床疗效，采用抗抑郁药副反应量表（SERS）及检查肝、肾功能及心电图的结果综合评定安全性。结果第6周末A组总有效率为89．09％；B组总有效率为78．94％；C组总有效率为73．61％；D组总有效率为66．27％。A组与B组差异有统计学意义（χ2=3．98，P〈0．05）；A组与C组比较差异有统计学意义（χ2=7．37，P〈0．01）；A组与D组比较差异有统计学意义（χ2=15．00，P〈0．01）。第1周末只有A组HAMD减分率〉50％，A组第1周治疗前后HAMD减分率差异有统计学意义（P〈0．01），而且明显高于B、C、D组第1周减分率。4组减分率相比较，差异均有统计学意义（P〈0．01）。A组起效时间为第一周末。B、C、D组起效时间均在两周以上。4组均有口干、头痛、便秘等不良反应，A、C组不良反应发生率对比，差异无统计学意义（P〉0．05），提示联合用药没有增加不良反应。结论噻奈普汀联合组治疗中重度抑郁症具有良好的疗效和安全性。且在治疗第一周内起效，可迅速提高患者对治疗的依从性，使患者早期树立信心，更好地配合治疗。

Tianeptine combined with flupentxol melitracen for depressive disorder

Objective To observe the effect of new method of Tianeptine combined with flupontxol melitra-cen for depressive disorder. Methods A total of 360 patients were randomly divided into four groups. Group A: 110 patients with Tianeptine and Flupontixol and Melitracen; Group B: 95 patients with Fluoxetine and Flupentixol and Melitracen; Group C: 72 patients with Tianeptine; Group D: 83 patients with Fhioxetine. The effects were as-sessed at the end of 1, 2, 4, 6 week after treatment. The treatment was considered effective if HAMD decreased more than 50%. The safety was evaluated with SERS, liver and kidney function test and ECG. Results The total effective response rate was 89.09% in group A, 78.94% in group B, 73.61% in group C and 66.27% in group D, respectively. The curative rate was significantly higher in the group A than that in other groups (A & B: x2=3.98, P<0.05; A & C:2 =7.37,P<0.01 ; A & D:2=15.00,P <0.01). The early curative effective re-sponse occurred only in group A after one week's treatment with HAMD. All the patients in the study have symptoms of dry mouth,headache and constipation without significance (P > 0.05 ). Conclusion Combination of Tianeptine and Flupontixol and Melitracen showes satisfactory curative effect and safety for depressive disorder.