坦度螺酮与美利曲辛合剂治疗焦虑和抑郁状态的疗效比较

目的：比较坦度螺酮与美利曲辛合剂治疗焦虑和抑郁状态的疗效。方法：将合并焦虑和抑郁状态的患者78例随机分为试验组39例（枸橼酸坦度螺酮治疗组，最终完成32例）和对照组39例（美利曲辛合剂治疗组，最终完成34例），进行随机开放平行对照研究，同时用汉密尔顿抑郁量表评分（HAMD）和汉密尔顿焦虑量表评分（HAMA）对其抑郁和焦虑状况进行治疗前及治疗后（第2，4，6周）的评估。结果：治疗组从用药后第2周开始患者HAMA评分显著减少（第2，4，6周均P〈0．01），从第4周开始HAMD评分显著减少（第4周P〈0．05，第6周P〈0．01）。对照组从用药后第2周开始，患者的HAMA评分和HAMD评分均明显减少（均为第2周P〈0．05，第4，6周P〈0．01）。治疗组HAMA减分差值高于对照组（第4周P〈0．05，第6周P〈0．01）；对照组HAMD减分差值高于治疗组（第2，6周均P〈0．01，第4周P〈0．05）。结论：坦度螺酮抗焦虑作用优于美利曲辛合剂，而抗抑郁作用则稍弱于美利曲辛合剂。坦度螺酮用于治疗合并广泛性焦虑障碍的严重抑郁症时，应该合并应用其他抗抑郁药。

Efficacy of tandospirone versus flupenthioxol/melitracen in the treatment of depression with anxiety

Objective:To compare the efficacy of tandospirone with flupenthixol/melitracen in the treatment of depression with anxiety. Methods:78 patients with depression with anxiety were randomly administered with either tandospirone (re =39 enrolled but 32 completed) or flupenthixol/melitracen (re =39 enrolled but 34 completed) for 6 weeks. The efficacy was evaluated based on Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) pre-treatment and in 2, 4, and 6 weeks post-treatment. Results:Both regimens significantly reduced the HAMA and HAMD. The tandospirone-treated patients showed a superior improvement in HAMA evaluation but inferior in HAMD evaluation to the flupenthixol/meltracen-treated patients. Conclusion:Adjunctive therapy of tandospirone with other anti-depressants for severe depression with anxiety should be considered.