不同年代抑郁症药物治疗的比较分析
发布时间：2018-12-06 13:17
【摘要】：目的:调查并比较不同年代某院住院抑郁症患者的药物使用情况,表明了医生对抑郁症治疗的用药变迁及现状,为抑郁症的临床合理用药提供参考。方法:采用回顾性研究方法,在某精神病专科医院病案室中查阅1995年、2005年、2015年抑郁症患者的住院病历,从中抽取符合入组标准的病历共234份,其中1995年43份、2005年96份、2015年95份。使用自制调查表收集患者的一般情况、用药情况等,采用SPSS19.0对数据进行统计处理。结果:234份病历中,患者年龄在26~50岁之间,平均(38.96±6.429)岁,其中男性96例(41.0%),女性138例(59.0%);总病程在0.5~240个月之间,平均(25.34±43.132)个月,住院时间14~192天,平均(42.64±27.928)天。(1)1995年40例(93.0%)患者使用了三环类抗抑郁药,3例(7.0%)患者未使用抗抑郁药;2005年35例(36.5%)患者服用了三环类抗抑郁药,80例(83.3%)患者服用了新型抗抑郁药,常用药物依次为帕罗西汀、氟西汀、文拉法辛、西酞普兰;2015年,所有患者均使用新型抗抑郁药,常用药物依次为度洛西汀、曲唑酮、舍曲林、帕罗西汀,仅有1例(1.1%)患者使用了三环类抗抑郁药。(2)1995年,34例(79.1%)患者使用一种抗抑郁药,3例患者(7.0%)同时使用两种抗抑郁药;2005年66例(68.8%)患者使用一种抗抑郁药,17例(17.7%)患者同时使用两种抗抑郁药;2015年42例(44.2%)患者使用一种抗抑郁药,47例(49.5%)患者同时使用两种抗抑郁药,3例(3.2%)患者同时服用三种抗抑郁药。(3)三个年代中分别有38例(88.4%)、91例(94.8%)和88例(92.6%)患者使用苯二氮卓类药物,使用最多的是氯硝西泮和阿普唑仑。其中1995年中有24例(55.8%)患者使用一种苯二氮卓类药物,10例(26.3%)患者同时服用两种苯二氮卓类药物,1例(2.6%)患者同时服用三种苯二氮卓类药物;2005年40例(44.0%)患者服用一种苯二氮卓类药物,9例(9.9%)患者同时服用两种苯二氮卓类药物;2015年35(39.8%)患者服用一种苯二氮卓类药物,39(44.3%)患者同时服用两种苯二氮卓类药物,3例(3.4%)患者同时服用三种苯二氮卓类药物(4)三个年代中,分别有22例(51.2%)、70例(72.9%)和58例(61.1%)患者服用了抗精神病药,其中服用一种抗精神病药分别为20例(90.9%)、40例(57.1%)、44例(75.9%);同时服用两种以上抗精神病药的有2例(9.1%)、26例(37.1%)和10例(17.2%)。(5)三个年代中合并心境稳定剂的分别占2例(4.7%)、20例(20.8%)、10例(10.5%)。(6)三个年代中,使用精神药物的总数量分别为(3.37±1.398)种、(4.52±1.451)种、(4.59±1.498)种。结论:1.随着时代的变迁,新型抗抑郁药治疗抑郁症已成为临床用药的主流,用药趋于多样化;2.抗抑郁药之间的合并用药增多;3.苯二氮卓类药物在抑郁患者中的使用增多;4.典型抗精神病药的使用减少,非典型抗精神病药的使用增多,两种以上抗精神病药同时使用明显增多;5.抑郁患者使用精神药物的总数目增加。
[Abstract]:Objective: to investigate and compare the drug use of depressive patients in a hospital in different years, and to show the changes and current situation of the treatment of depression by doctors, and to provide a reference for the rational use of depression in clinic. Methods: a retrospective study was carried out in a medical records room of a psychiatric hospital. 234 medical records of depression patients were collected from the medical records of 1995, 2005 and 2015. 234 medical records were collected from the medical records, 43 in 1995 and 96 in 2005. 95 in 2015. Self-made questionnaire was used to collect the general situation and drug use of patients, and SPSS19.0 was used to deal with the data. Results: the mean age of the patients was (38.96 卤6.429) years, 96 males (41.0%) and 138females (59.0%). The total course of disease ranged from 0.5 to 240 months, with an average of (25.34 卤43.132) months, and the hospitalization time was 140.192 days, with an average of (42.64 卤27.928) days. (1) in 1995, 40 patients (93.0%) were treated with tricyclic antidepressants. No antidepressants were used in 3 patients (7.0%). In 2005, 35 (36.5%) patients took tricyclic antidepressants and 80 (83.3%) patients took new antidepressants. The commonly used drugs were paroxetine, fluoxetine, venlafaxine and citalopram. In 2015, all patients were treated with new antidepressants, followed by doxicetine, trazodone, sertraline, paroxetine, and only one patient (1.1%) received tricyclic antidepressants. (2) in 1995, One antidepressant was used in 34 patients (79.1%) and two antidepressants in 3 patients (7.0%). One antidepressant was used in 66 patients (68.8%) and two antidepressants in 17 patients (17.7%) in 2005. In 2015, 42 patients (44.2%) were treated with one antidepressant and 47 (49.5%) with two antidepressants. Three patients (3.2%) took three antidepressants at the same time. (3) in the three decades, 38 (88.4%), 91 (94.8%) and 88 (92.6%) patients were treated with benzodiazepines, respectively. Clonazepam and alprazolam were used most frequently. In 1995, 24 patients (55.8%) received one benzodiazepines, 10 patients (26.3%) took two benzodiazepines, and one patient (2.6%) took three benzodiazepines at the same time. In 2005, 40 patients (44.0%) took one benzodiazepine and 9 patients (9.9%) took two benzodiazepines at the same time. In 2015, 35 (39.8%) patients took one benzodiazepine and 39 (44.3%) patients took two benzodiazepines at the same time. In 3 cases (3.4%), 22 cases (51.2%), 70 cases (72.9%) and 58 cases (61.1%) took antipsychotic drugs simultaneously. 20 cases (90.9%) were taken one antipsychotic drug, 40 cases (57.1%) and 44 cases (75.9%) respectively. Two patients (9.1%) took more than two antipsychotics at the same time, 26 cases (37.1%) and 10 cases (17.2%). (5) were treated with mood stabilizers in 2 cases (4.7%). In 20 cases (20.8%) and 10 cases (10.5%). (6), the total number of psychotropic drugs was (3.37 卤1.398) species, (4.52 卤1.451) species, (4.59 卤1.498) species, respectively. Conclusion: 1. With the change of times, new antidepressants have become the mainstream of clinical treatment of depression, drug use tends to diversification; 2. The combined use of antidepressants increased; The use of benzodiazepines in patients with depression increased; 4. The use of typical antipsychotics decreased, the use of atypical antipsychotics increased, more than two kinds of antipsychotics at the same time increased significantly. The total number of patients with depression using psychotropic drugs increased.
【学位授予单位】：济宁医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
本文编号：2366084
[Abstract]:Objective: to investigate and compare the drug use of depressive patients in a hospital in different years, and to show the changes and current situation of the treatment of depression by doctors, and to provide a reference for the rational use of depression in clinic. Methods: a retrospective study was carried out in a medical records room of a psychiatric hospital. 234 medical records of depression patients were collected from the medical records of 1995, 2005 and 2015. 234 medical records were collected from the medical records, 43 in 1995 and 96 in 2005. 95 in 2015. Self-made questionnaire was used to collect the general situation and drug use of patients, and SPSS19.0 was used to deal with the data. Results: the mean age of the patients was (38.96 卤6.429) years, 96 males (41.0%) and 138females (59.0%). The total course of disease ranged from 0.5 to 240 months, with an average of (25.34 卤43.132) months, and the hospitalization time was 140.192 days, with an average of (42.64 卤27.928) days. (1) in 1995, 40 patients (93.0%) were treated with tricyclic antidepressants. No antidepressants were used in 3 patients (7.0%). In 2005, 35 (36.5%) patients took tricyclic antidepressants and 80 (83.3%) patients took new antidepressants. The commonly used drugs were paroxetine, fluoxetine, venlafaxine and citalopram. In 2015, all patients were treated with new antidepressants, followed by doxicetine, trazodone, sertraline, paroxetine, and only one patient (1.1%) received tricyclic antidepressants. (2) in 1995, One antidepressant was used in 34 patients (79.1%) and two antidepressants in 3 patients (7.0%). One antidepressant was used in 66 patients (68.8%) and two antidepressants in 17 patients (17.7%) in 2005. In 2015, 42 patients (44.2%) were treated with one antidepressant and 47 (49.5%) with two antidepressants. Three patients (3.2%) took three antidepressants at the same time. (3) in the three decades, 38 (88.4%), 91 (94.8%) and 88 (92.6%) patients were treated with benzodiazepines, respectively. Clonazepam and alprazolam were used most frequently. In 1995, 24 patients (55.8%) received one benzodiazepines, 10 patients (26.3%) took two benzodiazepines, and one patient (2.6%) took three benzodiazepines at the same time. In 2005, 40 patients (44.0%) took one benzodiazepine and 9 patients (9.9%) took two benzodiazepines at the same time. In 2015, 35 (39.8%) patients took one benzodiazepine and 39 (44.3%) patients took two benzodiazepines at the same time. In 3 cases (3.4%), 22 cases (51.2%), 70 cases (72.9%) and 58 cases (61.1%) took antipsychotic drugs simultaneously. 20 cases (90.9%) were taken one antipsychotic drug, 40 cases (57.1%) and 44 cases (75.9%) respectively. Two patients (9.1%) took more than two antipsychotics at the same time, 26 cases (37.1%) and 10 cases (17.2%). (5) were treated with mood stabilizers in 2 cases (4.7%). In 20 cases (20.8%) and 10 cases (10.5%). (6), the total number of psychotropic drugs was (3.37 卤1.398) species, (4.52 卤1.451) species, (4.59 卤1.498) species, respectively. Conclusion: 1. With the change of times, new antidepressants have become the mainstream of clinical treatment of depression, drug use tends to diversification; 2. The combined use of antidepressants increased; The use of benzodiazepines in patients with depression increased; 4. The use of typical antipsychotics decreased, the use of atypical antipsychotics increased, more than two kinds of antipsychotics at the same time increased significantly. The total number of patients with depression using psychotropic drugs increased.
【学位授予单位】：济宁医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
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