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帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁障碍的临床观察
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篇名: 帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁障碍的临床观察
TITLE:
摘要: 目的: 观察帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁的疗效和安全性。方法: 120例脑卒中后重性抑郁障碍患者随机分为A组(40例)、B组(40例)和C组(40例)。所有患者均给予脑卒中的常规治疗;在此基础上,A组患者给予盐酸帕罗西汀肠溶缓释片25 mg,口服,每日1次;B组患者给予氟哌噻吨美利曲辛片20 mg,口服,每日2次;C组患者给予盐酸帕罗西汀肠溶缓释片(用法用量同A组)+氟哌噻吨美利曲辛片(用法用量同B组)。各组均连用28 d。观察各组患者的临床疗效,治疗前后神经功能缺损程度(NIHSS)评分、日常生活能力(ADL)评分、汉密尔顿抑郁量表(HADM)评分、生活质量评定量表(SS-QOL)评分,住院天数及不良反应发生情况。结果:C组患者总有效率显著高于A、B组,住院天数显著少于A、B组,差异均有统计学意义(P<0.05);但A、B两组间比较差异均无统计学意义(P>0.05)。各组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗前,各组患者NIHSS、ADL、HADM、SS-QOL评分比较,差异均无统计学意义(P>0.05)。治疗10、28 d后,各组患者NIHSS、HADM、SS-QOL评分均显著低于同组治疗前,随治疗时间延长逐渐降低,且C组显著低于A、B组同期;各组患者ADL评分均显著高于同组治疗前,随治疗时间延长逐渐升高,且C组显著高于A、B组同期,差异均有统计学意义(P<0.05);但A、B两组间比较差异均无统计学意义(P>0.05)。结论:在常规治疗的基础上,帕罗西汀联合氟哌噻吨美利曲辛治疗脑卒中后重性抑郁障碍的疗效显著,可减轻神经功能损伤,改善抑郁症状,提高生活质量,且未增加不良反应的发生。
ABSTRACT: OBJECTIVE: To observe therapeutic efficacy and safety of paroxetine combined with flupentixol melitracen in the treatment of post-stroke major depressive disorder (PSMDD). METHODS: 120 PSMDD patients were randomly divided into group A (40 cases), group B (40 cases) and group C (40 cases). All patients received routine stroke treatment; group A was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet 25 mg orally, once a day; group B was additionally given Flupentixol melitracen tablet 20 mg orally twice a day; group C was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet (same usage and dosage as group A)+flupentixol melitracen (same usage and dosage as group B). Three groups were treated for 28 d. Clinical efficacies of 3 groups were observed as well as NIHSS, ADL, HADM, SS-QOL score, hospitalization stay and the occurrence of ADR. RESULTS: Total response rate of group C was significantly higher than those of group A and B; hospitalization day was significantly less than those of group A and B, with statistical significance (P<0.05); there was no statistical significance between group A and B (P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). Before treatment, there was no statistical significance in NIHSS, ADL, HADM, SS-QOL score among 3 groups (P>0.05). After 10, 28 d of treatment, NIHSS, HADM, SS-QOL score of 3 groups were significantly lower than before,above indexes were decreased gradually as time, and the group C were lower than the group A and B; ADL score of 3 groups were significantly higher than before, this index was increased gradually as time, and the group C were lower than the group A and B with statistical significance (P<0.05); there was no statistical significance between group A and B (P>0.05). CONCLUSIONS: Based on routine treatment, paroxetine combined with flupentixol melitracen  in the treatment of PSMDD can relieve neurologic function injury, improve depression condition and the quality of life without increasing the occurrence of ADR.
期刊: 2017年第28卷第9期
编辑: 张丽雅,何佳,徐东勋
AUTHORS: ZHANG Liya,HE Jia,XU Dongxun
关键字: 帕罗西汀;氟哌噻吨美利曲辛;脑卒中后重性抑郁障碍;疗效;安全性
KEYWORDS: Paroxetine; Flupentixol melitracen; Post-stro- ke major depressive disorder; Efficacy; Safety
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