坦度螺酮对癫痫伴发抑郁与焦虑的临床研究

发布时间：2018-02-02 15:49

本文关键词： 癫痫 5-HT1A受体激动剂坦度螺酮抑郁焦虑　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过对汉密尔顿抑郁量表(HAM-D)及汉密尔顿焦虑量表(HAM-A)的测评,观察5-TH1A受体激动剂枸橼酸坦度螺酮对癫痫合并抑郁与焦虑患者治疗的疗效,为癫痫后抑郁与焦虑的临床诊断和治疗提供新思路。方法：收集山西医科大学第一临床医院及山西医科大学第三医院神经内科2012.11—2013.11门诊及住院的癫痫合并焦虑抑郁患者134例,分为治疗组91例和对照组43例。治疗组在常规口服抗癫痫药物及心理疏导的基础上加服坦度螺酮,每次lOmg,每日三次；对照组服用常规抗癫痫药物接受心理疏导,疗程8周。两组分别在使用5-羟色胺1A受体激动剂枸橼酸坦度螺酮治疗前和治疗后2周、4周、8周进行汉密尔顿抑郁量表(HAM-D)及汉密尔顿焦虑量表(HAM-A)评分变化,评定抑郁、焦虑情况。同时记录每组病人服药期间癫痫发作次数的改变。统计采用SPSS17.0统计软件包进行统计。HAMA及HAMD评分以均数±标准差(x+s)表示,比较采用配对t检验,P0.05差异有统计学意义。根据数据特征,癫痫发作次数用中位数(四分位间距)[M(P25,p75)]表示,两组间比较采用Mann-Whitney U检验,P0.05差异有统计学意义。癫痫疗效及焦虑抑郁疗效两组间比较采用卡方(X2)检验,P0.05差异有统计学意义。结果：1.治疗2周末,治疗组与对照组比较无明显差异(P0.05)；4周末开始,治疗组与对照组比较,治疗后HAMD评分与HAMA评分均显著性减低。治疗4周后,治疗组前后比较,HAMD评分与HAMA评分(P0.05)均明显下降；2.与对照组比较,治疗组随访8周后发作次数明显减少,有统计学意义(U=-2.92,P0.05)。3.两组未见严重不良反应,枸橼酸坦度螺酮具有很好的安全性。结论：通过治疗组及对照组患者治疗前及治疗后2、4、8周对汉密尔顿抑郁量表(HAM-D)及汉密尔顿焦虑量表(HAM-A)测评结果显示：1)5-TH1A受体激动剂枸橼酸坦度螺酮对伴有焦虑与抑郁状态的癫痫患者可以全面改善焦虑抑郁障碍的所有症状,有助于纠正患者的负面情绪,提高治愈率；2)5-TH1A受体激动剂枸橼酸坦度螺酮可对于合并焦虑与抑郁状态的癫痫患者可以减少癫痫的发作,是良好的药物。3)随着用药时间的延长抗焦虑,抗抑郁的疗效越好。
[Abstract]:Objective: to evaluate the Hamilton Depression scale (Hamilton Depression scale) and Hamilton anxiety scale (Hamilton anxiety scale). To observe the efficacy of 5-TH1A receptor agonist tandosterone citrate in the treatment of epileptic patients with depression and anxiety, and to provide a new idea for the clinical diagnosis and treatment of post-epileptic depression and anxiety. Methods: 134 patients with epilepsy complicated with anxiety and depression were collected from the first Clinical Hospital of Shanxi Medical University and the Department of Neurology of the third Hospital of Shanxi Medical University from November to March 2012.11. The treatment group was divided into treatment group (n = 91) and control group (n = 43). The control group was treated with conventional antiepileptic drugs for 8 weeks. The two groups were treated with 5-hydroxytryptamine 1A receptor agonist tandoproxone citrate for 4 weeks before and 2 weeks after treatment. After 8 weeks, the scores of Hamilton Depression scale (Hamd) and Hamilton anxiety scale (Hamilton anxiety scale) were changed to assess depression. Anxiety. At the same time, the changes of epileptic seizures in each group were recorded. The mean 卤standard deviation of Hama and HAMD scores were calculated by SPSS17.0 statistical software package (P < 0.05). S). There was significant difference in pairing t test (P0.05). According to the characteristics of the data, the number of epileptic seizures was median (quartile spacing). [Mann-Whitney U test was used to compare the two groups. There was significant difference between the two groups in the therapeutic effect of epilepsy and anxiety and depression by chi-square X _ 2) test (P0.05). Results 1. At the end of 2 weeks, there was no significant difference between the treatment group and the control group (P 0.05). From the end of the 4th week, the HAMD score and HAMA score of the treatment group were significantly lower than those of the control group, and after 4 weeks of treatment, the comparison was made between the treatment group and the control group. HAMD score and HAMA score decreased significantly (P 0.05). 2.Compared with the control group, the number of seizures in the treatment group decreased significantly after 8 weeks follow-up, and there was no serious adverse reaction in the two groups. Tandoxone citrate has good safety. Conclusion: the patients in the treatment group and the control group were treated before and after treatment. In 8 weeks, the Hamilton Depression scale (Hamm) and the Hamilton anxiety scale (Hamilton anxiety scale) showed that: 1). The 5-TH1A receptor agonist tandolone citrate can improve all symptoms of anxiety and depression in epileptic patients with anxiety and depression. It is helpful to correct the negative emotion of the patients and improve the cure rate. 2Tanduspirone citrate, the agonist of 5-TH1A receptor, can reduce seizures in epileptic patients complicated with anxiety and depression. It is a good drug. 3) with the prolongation of medication time, anti-anxiety. The better the antidepressant effect.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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