度洛西汀联合心脑宁胶囊对晚发性抑郁的疗效观察

发布时间：2018-06-22 01:54

本文选题：度洛西汀 + 心脑宁胶囊　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:观察度洛西汀及心脑宁胶囊联合用药对晚发性抑郁患者认知功能的作用和临床疗效。方法:根据入组排除标准选2015年8月-2016年12月兰州大学第二医院门诊或住院晚发性抑郁症患者70例(病例组),限制性随机分组分联合组(度洛西汀联合心脑宁胶囊)和西药组(度洛西汀),治疗前与治疗第2、4、8、12周末采用汉密尔顿抑郁量表(HAMD-24)评定抑郁程度及药物副反应量表评定不良反应;治疗前与治疗第12周末进行认知功能测评(数字广度、无意义图形再认、连线测试、数字符号、威斯康星卡片分类测验、字色干扰试验、词汇流畅性测验)和日常生活能力量表测评。根据入组标准选50例健康老年人(正常对照组)进行认知功能和日常生活能力测评。比较治疗前病例组与正常对照组认知功能和日常生活能力;比较联合组与西药组疗效、对认知功能的作用和不良反应;比较治疗后联合组与正常对照组认知功能和日常生活能力。结果:1.治疗前病例组在数字广度-顺背、无意义图形再认、数字符号、数字广度-倒背、WCST完成分类数、stroop-c、stroop-cw、词汇流畅性测验等认知功能相关测试评分均低于正常对照组,差异有统计学意义(P0.01);WCST随机错误数、WCST持续错误数、连线测试A、连线测试B、ADL评分均高于正常对照组,差异有统计学意义(P0.01)。2.HAMD24评分重复测量方差分析结果显示:组间和组内差异均有统计学意义(P0.05或P0.01);时间与分组无交互作用(P0.05)。组间各时间点比较,治疗第2、4周末联合组与西药组HAMD24评分差异无统计学意义(P0.05),治疗第8、12周末联合组HAMD24评分低于西药组,差异有统计学意义(P0.05)。联合组有效率高于西药组(91.43%vs.71.43%),差异有统计学意义(P0.05),痊愈率(28.57%vs.20.00%)差异无统计学意义(P0.05)。3.治疗第12周末,组内比较,联合组数字广度-顺背、无意义图形再认、数字符号、数字广度-倒背、WCST完成分类数、stroop-c、stroop-cw、词汇流畅性测验评分均高于治疗前,WCST随机错误数、WCST持续错误数、连线测试A、连线测试B、ADL评分均低于治疗前,差异显著(P0.01);西药组数字广度-顺背、无意义图形再认、数字符号、数字广度-倒背评分均高于治疗前,连线测试A、连线测试B、ADL评分低于治疗前,差异显著(P0.01),WCST完成分类数、WCST随机错误数、WCST持续错误数、stroop-c、stroop-cw、词汇流畅性测验评分与治疗前相比,差异无统计学意义(P0.05)。治疗第12周末,组间比较,联合组数字符号、数字广度-倒背、WCST完成分类数、stroop-c、stroop-cw、词汇流畅性测验评分均高于西药组,WCST随机错误数、WCST持续错误数、连线测试B、ADL评分低于西药组,差异有统计学意义(P0.05或P0.01),数字广度-顺背、无意义图形再认、连线测试A与西药组比较,差异无统计学意义(P0.05)。4.治疗第12周末,联合组数字广度-顺背、无意义图形再认、数字广度-倒背、WCST完成分类数、stroop-c、stroop-cw、词汇流畅性测验评分均低于正常对照组,连线测试A、WCST随机错误数、WCST持续错误数、连线测试B、ADL评分均高于正常对照组,差异有统计学意义(P0.01或P0.05);联合组数字符号评分与正常对照组差异无统计学意义(P0.05)。5.联合组与西药组不良反应事件发生频率差异无统计学意义(χ2=0.467,P0.05)。结论:1.晚发性抑郁患者存在短时记忆、注意、执行功能等认知功能障碍。2.度洛西汀联合心脑宁胶囊与单用度洛西汀治疗晚发性抑郁均有效,安全性均好。3.联合心脑宁胶囊比单用度洛西汀治疗LOD的抗抑郁疗效更显著,对持续性注意、注意的转换功能和执行功能方面认知损害的改善作用更明显。
[Abstract]:Objective: To observe the effect and clinical effect of duloxetine and Xin nnning Capsule on the cognitive function of patients with late onset depression. Methods: according to the exclusion criteria, 70 cases of late onset depression in Second Hospital Affiliated to Lanzhou University in August 2015, December, -2016 (case group), restricted randomized grouping combined group (duloxi) Tine and Xin nnning capsule) and Western medicine group (duloxetine), before and after treatment for 2,4,8,12 weekend, the Hamilton Depression Scale (HAMD-24) was used to assess the depressive degree and drug side reaction scale to assess the adverse reaction. The cognitive function assessment (Digital breadth, meaningless graphic recognition, connection test, digital character) before and twelfth weekend treatment was evaluated. Number, Wisconsin card classification test, word color interference test, vocabulary fluency test, and daily living capacity scale assessment. The cognitive function and daily living ability of 50 healthy elderly people (normal control group) were selected according to the standard of entry group. The cognitive function and daily living ability of the pre treatment and normal control group were compared. The effect of combination group and Western Medicine Group on cognitive function and adverse reaction; compare the cognitive function and daily life ability of the combined group and the normal control group after treatment. Results: 1. before treatment, the case group was in the digital breadth - CIS back, no meaningful graphic recognition, digital symbols, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, fluency of vocabulary. The score of cognitive function test, such as sex test, was lower than that of the normal control group, and the difference was statistically significant (P0.01); the WCST random error number, the WCST continuous error number, the connection test A, the connection test B, and the ADL score were all higher than those of the normal control group, the difference was statistically significant (P0.01) and the results of the repeated measurement of variance analysis of.2.HAMD24 score showed: in group and in group The difference was statistically significant (P0.05 or P0.01); there was no interaction between time and group (P0.05). There was no significant difference in the HAMD24 score between the combination group and the western medicine group at the end of the group 2,4 weekend (P0.05). The HAMD24 score of the combined group was lower than that in the western medicine group (P0.05). The effective rate of the combined group was high. In the western medicine group (91.43%vs.71.43%), the difference was statistically significant (P0.05), and the difference in recovery rate (28.57%vs.20.00%) was not statistically significant (P0.05) for the twelfth weekend of.3. treatment. In the group, the combined group digital breadth - CIS back, no meaningful graphic recognition, digital symbols, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, vocabulary fluency test The scores were all higher than before the treatment, WCST random error number, WCST continuous error number, line test A, line test B, ADL score were lower than before treatment, the difference was significant (P0.01); the western medicine group digital breadth - CIS back, no meaningful graphic recognition, digital symbol, digital breadth - back score were higher than before treatment, connection test A, connection test B, ADL score below treatment Before, the difference was significant (P0.01), the number of WCST completed, the number of WCST random errors, the number of WCST continuous errors, stroop-c, stroop-cw, and the vocabulary fluency test score was not statistically significant (P0.05). The twelfth weekend, the group comparison, the combined group digital symbols, the digital breadth back, the WCST complete classification, stroop-c, stroop-cw, and the vocabulary. The fluency test scores were higher than the western medicine group, the WCST random error number, the WCST continuous error number, the connection test B, and the ADL score lower than the western medicine group, the difference was statistically significant (P0.05 or P0.01), the digital breadth - CIS back, the non sense graphic recognition, the connection test A and the western medicine group, the difference was not statistically significant (P0.05).4. treatment twelfth weekend, the combined group number Word breadth - CIS back, nonsense graphic recognition, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, the vocabulary fluency test scores were lower than the normal control group, the line test A, the WCST random error number, the WCST continuous error number, the connection test B, the ADL score higher than the normal control group, the difference was statistically significant (P0.01 or P0.05); the difference was statistically significant (P0.01 or P0.05); the difference was statistically significant (P0.01 or P0.05); the statistical significance was statistically significant (P0.01 or P0.05); the statistical significance was statistically significant There was no significant difference between the score of group digital symbols and the normal control group (P0.05) there was no significant difference in the frequency of adverse events between the.5. combined group and the western medicine group (x 2=0.467, P0.05). Conclusion: 1. the patients with late onset depression have short time memory, attention, executive function and other cognitive dysfunction.2. degrees luoxetine combined heart NanNin capsule and single The use of luoxetine is effective in the treatment of late onset depression. The safety of.3. combined with cardio NanNin capsule is more significant than that of single use luoxetine in the treatment of LOD. It is more significant for the improvement of cognitive impairment in continuous attention, attention to conversion and executive function.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4

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