摘要
目的探讨艾司西酞普兰联合左旋甲状腺素钠治疗抑郁症并发亚临床甲状腺功能减退(SCH)的疗效及不良反应。方法选择符合CCMD-3抑郁症诊断标准,同时并发SCH的患者33例作为治疗组(A组)。选择与A组同期、同质的抑郁症患者为对照组1组(简称B组);选择同期、同质且无SCH抑郁症患者为对照组2组(C组)。B、C两组每组33例。3组均服艾司西酞普兰,有睡眠障碍的患者允许使用唑吡坦,A组患者口服左旋甲状腺素钠,研究全程6周。入组时及治疗后的第1,2,4,6周末分别进行蒙哥马利-艾森伯格抑郁评价量表(MADRS)、不良反应量表(TESS)评定。以MADRS总分减分率评定疗效。第6周末复查血常规、肝肾功能、心电图。结果 3组患者的年龄,病期,服用艾司西酞普兰、唑吡坦例数,剂量,基线MADRS得分均差异无显著性(P>0.05)。第1周末3组患者的MADRS得分均明显下降(P<0.05),但第4,6周更为显著(P<0.01)。经两两比较,A、C两组的MADRS得分与B组比较,下降更为迅速、明显(P<0.05),A、C两组MADRS得分平行下降(P>0.05)。3组治疗过程>5%的不良反应出现率基本相同(P>0.05),且比较轻微。第6周末,A、C组各有1例转氨酶轻度升高,其他各项检查均在正常范围内。第6周末,A、C两组临床有效率、治愈率均差异无显著性(P>0.05)。A组的临床有效率高于B组(P<0.05),但临床治愈率两组差异无显著性(P>0.05)。C组的临床有效率、治愈率高于B组(P<0.05)。结论对抑郁症并发SCH的患者在应用抗抑郁药物的同时,合用左旋甲状腺素钠安全,且可以促进、加快抑郁症的缓解,提高临床治愈率。
Objective To study the efficacy and untoward effects of treatment for depression with subclinical hypothyroirlisn（SCH）by escitalopram. Methods 33 patients consistent with the diagnosed criteria of CCMD-3 depression and complicated with subclinical hypothyroirlisn （SCH）were regarded as treatment group （Group A）. Meanwhile,33 patients suffering from depression with SCH at the same time were as control group one （Group B） and 33 others who had depression at the same time but no SCH as control group two （Group C）. All the patients in three groups took escitalopram. Those with sleep disorder took zolpidem and those in group A were also asked to take levothyroxime sodium at the same time and lasted for 6 weeks. At the end of the first,second,fourth and sixth weeks treatment,they were tested by MADRS and TESS and the efficacy was judged by decrease of MADRS. Six weeks later,blood,liver,kidney and electrocardiogram were re-examined. Results The age,duration and doze of escitalopram among three groups shown no difference（P0.05） tested by MADRS. At the end of the first week,scores in three groups decreased apparently（P0.05）,especially at the fourth and sixth week（P0.01）. The scores in Group A and Group C decreased in parallel,and more rapidly and obviously compared with group B（P0.05,P0.01）. Three groups showed the same incidence of more than 5% untoward effect（P0.05）and side effects were slight. At the end of the sixth week,one case had slight increase of hepatic enzyme,others were normal. The clinical efficiency and cure in Group A and C had no statistics meaning（P0.05）. The clinical efficiency of Group A was higher than that in Group B（P0.05）. Both clinical efficiency and cure rate in Group C were higher than those in Group B（P0.05）. Conclusion It is safe to treat those suffering from depression with SCH with anti-depression medicine together with levothyroxime sodium,which helps to ease the depression and increase clinical cure rate.
出处
《医药导报》
CAS
2010年第9期1154-1156,共3页
Herald of Medicine
