艾司西酞普兰与西酞普兰治疗女性老年抑郁症伴焦虑患者的随机对照研究

目的探讨抗抑郁药物艾司西酞普兰对女性老年抑郁症伴焦虑患者的治疗效果和安全性。方法对77例门诊和住院女性老年期抑郁症伴焦虑的患者按照诊疗顺序用随机数字表随机决定服用艾司西酞普兰(研究组)和西酞普兰(对照组),研究组39例,对照组38例。应用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)筛选入组患者和评定疗效,副反应量表(TESS)、糖脂代谢生化指标和体重指数评定不良事件。结果与治疗前比较两组HAMD、HAMA评分在治疗2、4、6、8周均有统计学意义(t=8.75~18.08,P均0.01),研究组治疗1周评分即有统计学意义,HAMD(t=2.52,P0.05)、HAMA(t=5.30,P0.01),对照组治疗1周仅HAMA评分有统计学意义(t=2.19,P0.05)。两组间HAMD、HAMA评分治疗前比较无统计学意义(t=-0.11和0.64,P0.05),治疗1周比较HAMA评分有统计学意义(t=-2.18,P0.05)、治疗2、4周比较HAMD评分有统计学意义(t=-2.58和-2.14,P0.05)。TESS统计两组不良事件发生率分别为23.08%和28.95%,差异无统计学意义;两药对糖脂代谢和体质量均无明显影响。结论艾司西酞普兰与西酞普兰对女性老年期抑郁症伴焦虑的患者均有较好疗效和安全性,艾司西酞普兰对抑郁症状和焦虑症状起效更快。

Escitalopram and Citalopram for Female Patients with Geriatric Depression and Anxiety A Razed Controlled Trial

Objective To investigate the clinical efficacy and security of escitalopram and citalopram in the treatment of female patients with geriatric depression and anxiety. Methods A total of 77 cases of outpatient and inpatient female patients with senile depression and anxiety were randomly assigned to take escitalopram（ Study Group）or citalopram（ control group）. Study group contained 39 cases while 38 cases in the control group. Patients were screened and clinical efficacy was assessed with Hamilton Depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA）. The Side Effects Scale （TESS）, Glycolipid Metabolic Markers and Body Mass Index were used to assess adverse events. Results HAMD, HAMA scores of the two groups after treated two weeks, four weeks, six weeks, eight weeks were statistically significantly different from those before treatment（ t = 8.75 - 18.08 ,P 〈 0.01 ）. the scores of HAMD and HAMA after treated one week in study group were statistically significantly different from those before treatment （t = 2.52,5.30;P 〈 0.05 ）. In control group, only HAMA score one week after treated was statistically significantly different from that before treatment（ t = 2.19,P 〈 0. 05 ）. there was no statistically significant difference between the two groups （ t = -0.11 and 0.64, P 〉 0.05 ） , HAMA score of one week af- ter treated was statistically significantly changed （ t = -2.18, P 〈 0.05 ） , HAMA score of two weeks, four weeks after treated were statisti- cally significantly changed（ t =-2.58 and-2.14 ,P 〈 0.05 ）. The incidence of adverse events in study group and control group were 23. 08% and 28.95%, the difference was not statistically significant;Two drugs had no significant effects on lipid metabolism and body weight. Conclusion Escitalopram and citalopram all have better efficacy and safety in the treatment of female patients with geriatric depression and anxiety, escitalopram takes effect faster on depression and anxiety.