文拉法辛联合中药治疗中老年抑郁症的临床疗效研究与ECT的相关因素分析

发布时间：2017-12-31 06:06

本文关键词：文拉法辛联合中药治疗中老年抑郁症的临床疗效研究与ECT的相关因素分析　出处：《兰州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨文拉法辛联合中药治疗中老年抑郁症的临床疗效及其与ECT的相关因素分析。方法：将89例符合国际疾病分类第十版(ICD-10)抑郁症患者,按诊疗卡号的奇偶分为观察组(45例)和对照组(44例)。对照组给予文拉法辛治疗,观察组在使用文拉法辛治疗的同时给予中药进行联合治疗,采用汉密尔顿抑郁量表(HAMD24)评定临床疗效,不良反应量表(TESS)评定副反应,分别在治疗前和治疗后第1,2,4,6,8周末评估其疗效和安全性；并于治疗前及治疗第8周末进行ECT检查并记录检查结果。结果： 1.与治疗前比较,观察组自第1周末HAMD24量表评分明显降低,对照组自第2周末HAMD24量表评分才明显降低,差异有统计学意义(P0.05)； 2.两组焦虑／躯体化因子评分自第4周末起差异有统计学意义(P0.05)； 3.患者ECT检查脑部灌注有无异常与患者年龄和病程呈正相关,与文化程度及性别无相关性； 4.ECT检查结果与焦虑／躯体化因子评分中度相关(r=0.67,P0.05)； 5.观察组和对照组痊愈率(26.83%,22.50%)、有效率(87.80%,80.00%)差异无统计学意义(P0.05)不良反应事件发生率差异无统计学意义(χ2=1.99,P0.05)。结论： 1.年龄越愈大病程愈长,脑部断层血流灌注异常愈明显；年龄和病程是中老年人脑部血流异常的危险因素； 2.焦虑／躯体化因子评分愈高,脑部断层血流灌注异常愈明显； 3.文拉法辛联合中药和单一文拉法辛治疗中老年抑郁症均有良好疗效及安全性,但文拉法辛联合中药起效更快,值得临床推广。
[Abstract]:Objective: To investigate the clinical effect of venlafaxine combined with traditional Chinese medicine in the treatment of depression in middle and old age and its related factors with ECT. Methods: 89 patients with depression according to ICD-10 were divided into two groups: observation group (45 cases) and control group (44 cases). The control group was treated with venlafaxine. The observation group was treated with venlafaxine and combined with traditional Chinese medicine. The clinical efficacy was evaluated by Hamilton Depression scale (Hamd 24) and the side effects were evaluated by adverse reaction scale (TESS). The efficacy and safety were evaluated before and after treatment at the end of 8 weeks. ECT examination was performed before treatment and at the end of the 8th week of treatment, and the results were recorded. Results: 1. Compared with before treatment, the HAMD24 score of the observation group decreased significantly from the first weekend, and that of the control group decreased significantly from the 2nd weekend. The difference was statistically significant (P 0.05). 2. The scores of anxiety / somatization factor in the two groups were significantly different from the end of the 4th week (P 0.05). 3.The abnormal cerebral perfusion in ECT was positively correlated with age and course of disease, but had no correlation with education level and sex. 4. The results of ECT were moderately correlated with anxiety / somatization factor scores (P 0.05). 5. The cure rate of observation group and control group was 26.83% and 22.50%, and the effective rate was 87.80%. There was no significant difference in the incidence of adverse reaction events (蠂 2, 1.99, P 0.05). Conclusion: 1. The longer the age, the more obvious the abnormal perfusion of cerebral blood flow, age and course of disease are the risk factors of cerebral blood flow abnormality in the middle and old people. 2. The higher the score of anxiety / somatization factor, the more obvious the abnormal blood flow and perfusion in the brain; 3. Venlafaxine combined with Chinese medicine and venlafaxine alone have good efficacy and safety in the treatment of middle and old age depression, but venlafaxine combined with traditional Chinese medicine is more effective and worthy of clinical promotion.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.4

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