帕罗西汀联合无抽搐电休克治疗难治性抑郁症的临床研究

目的 评价帕罗西汀联合无抽搐电休克（MECT）治疗难治性抑郁症的疗效及不良反应.方法 将符合入组标准的80例患者随机分为联合治疗组（研究组）和帕罗西汀组（对照组）,共观察6周,分别于治疗前和治疗后第1、2、4、6周末采用汉密尔顿抑郁量表（HAMD）评定临床疗效,采用治疗中需处理的不良反应症状量表（TESS）评定不良反应.结果 治疗结束时研究组有效率显著高于对照组（分别为65.0％和42.5％,P＜0.01）.研究组治疗后第1周末起HAMD评分显著降低（P＜0.05）,而对照组治疗后第2周末起HAMD评分显著降低（P＜0.05）;治疗后第2周末起HAMD评分研究组低于对照组（P＜0.05）.两组总体不良反应发生率比较无显著性差异（P＞0.05）,在头痛、性功能障碍方面比较差异有统计学意义（P＜0.05）.结论 帕罗西汀联合MECT治疗难活性抑郁症疗效显著,起效快,优于单用帕罗西汀治疗.

A study of Paroxetine combined Modified electroconvulsive therapy in the treatment of Refractory depression

Objective To evaluate the efficacy and safety of paroxetine and MECT in treating refractory depression. Methods 80 patients with refractory depression were randomly assigned into study group treated with MECT for 6 weeks and control group treated with paroxetine for 6 weeks. All patients were assessed with Hamilton Depressive Scale （ HAMD ） and Treatment Emergent Symptom Scale （TESS） at the baseline and at the end of the 1 ^at, 2^nd, 4^th, 6^th week of the treatment to evaluate the efficacy and the side effects. Results The response rate in study was significantly higher than that in control group at the end of the 6-week treatment （65.0% vs. 42.5%, P 〈0.01）. Compared with the baseline, score of HAMD in study group decreased significantly （P 〈 0.05） from the end of the 1 s, week, but score of HAMD in control group decreased significantly （P 〈 0.05） from the end of the 2^nd week of the treatment. Scores of HAMD in study group were significantly lower than those in control group at the end of the 2^nd, 4^th, 6^th week of the treatment （P 〈 0.05）. There was no significant difference in global incidence rate of side effects between the two groups （P 〉 0.05）, but the incidence rate of headache and sexual disorder in study group were significantly lower than those in control group （P 〈 0.05 ）. Conclusion Compared with paroxetine, Paroxetine combined MECT has better efficiency and takes effect more quickly in the treatment of refractory depression.