伏硫西汀治疗首发抑郁症患者的临床效果观察

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目的:探讨伏硫西汀治疗首发抑郁症患者的临床效果。方法:选取温州康宁医院2018年1月至2019年1月治疗的首发抑郁症患者100例为研究对象,采用随机数字表法分为对照组50例、观察组50例。对照组给予氟西汀治疗,观察组给予伏硫西汀治疗,两组持续治疗8周。比较两组治疗前后认知功能评分,检测两组治疗前后脑源性神经营养因子(BDNF)、同型半胱氨酸(Hcy)、肿瘤坏死因子(TNF-α)、1,25二羟维生素Dn 3[1,25-(OH)n 2Dn 3],检测两组电生理指标事件相关电位P300,采用汉密尔顿抑郁量表(HAMD)评价患者治疗前后精神焦虑状况,评价两组临床治疗效果。n 结果:治疗4周、8周,对照组认知功能评分分别为(24.96±2.85)分、(26.18±3.16)分,观察组别为(28.65±3.32)分、(32.66±3.81)分,两组均明显高于治疗前(对照组:n F=14.821;观察组:n F=10.632,均n P<0.01),治疗8周时两组认知功能评分均明显高于治疗4周(对照组:n t=2.027,n P=0.045,观察组:n t=5.611,n P=0.000)。治疗后,对照组BDNF、Hcy、TNF-α、1,25-(OH)n 2Dn 3分别为(29.74±3.62)ng/L、(18.46±2.34)μmol/L、(314.11±15.87)ng/L、(30.69±4.17)ng/mL,观察组分别为(34.22±2.85)ng/L、(14.55±2.17)μmol/L、(286.55±10.11)ng/L、(34.92±4.28)ng/mL,两组差异均有统计学意义(n t=6.876、8.663、10.357、5.005,均n P<0.01);治疗后,对照组P300潜伏期、P300波幅分别为(426.94±4.72)ms、(0.62±-4.31)μV,观察组分别为(413.65±3.66)ms、(0.84±-4.76)μV,两组差异均有统计学意义(n t=15.734、3.048,均n P<0.01);治疗后,观察组HAMD评分[(10.72±1.53)分]明显低于对照组[(12.93±1.84)分](n t=6.530,n P0.05)。n 结论:伏硫西汀治疗首发抑郁症患者可较好的改善患者认知功能和临床症状,改善患者BDNF、HCY、TNF-α、1,25-(OH)n 2Dn 3等生化指标。n “,”Objective:To investigate the clinical effect of vortioxetine in the treatment of patients with first-episode depression.Methods:From January 2018 to January 2019, 100 patients with depression in outpatients or inpatients of Wenzhou Kangning Hospital were enrolled in the study.According to different treatment methods, they were divided into control group and observation group according to the random digital table method, with 50 cases in each group.The control group was given fluoxetine 20-40mg, qd, and the observation group was treated with vortioxetine.Both two groups were treated for 8 weeks.The pre-treatment subjective cognitive function of the two groups was evaluated.Brain-derived neurotrophic factor(BDNF), homocysteine (Hcy), tumor necrosis factorα(TNF-α), 1, 25-hydroxyl vitamin Dn 3[1, 25-(OH)n 2Dn 3] were detected in two groups.The electrophysiological indicators event-related potential P300 were detected.The Hamilton Depression Scale(HAMD) was used to evaluate the mental anxiety, mood and physical anxiety of patients before and after treatment in the two groups.The clinical effects of the two groups were evaluated and the adverse reactions were recorded.n Results:After treatment for 4 weeks and 8 weeks, the cognitive function scores of the control group were (24.96±2.85)points and (26.18±3.16)points, respectively, which of the observation group were (28.65±3.32)points and (32.66±3.81)points, respectively, which were significantly higher than before treatment(control group: n F=14.821; observation group: n F=10.632, all n P<0.01). The cognitive function scores of the two groups after treatment for 8 weeks were significantly higher than treatment for 4 weeks (control group:n t=2.027, n P=0.045, observation group: n t=5.611, n P=0.000). After treatment, the levels of BDNF, Hcy, TNF-α, 1, 25-(OH)n 2Dn 3 in the control group were (29.74±3.62)ng/L, (18.46±2.34)μmol/L, (314.11±15.87)ng/L, (30.69±4.17)ng/mL, respectively, which in the observation group were (34.22±2.85)ng/L, (14.55±2.17)μmol/L, (286.55±10.11)ng/L, (34.92±4.28)ng/m, respectively, the differences between the two groups were statistically significant(n t=6.876, 8.663, 10.357, 5.005, all n P<0.01). After treatment, the P300 latency and P300 amplitude of the control group were (426.94±4.72)ms, (0.62±-4.31)μV, respectively.which of the observation group were (413.65±3.66)ms, (0.84±-4.76)μV, respectively, the differences between the two groups were statistically significant(n t=15.734, 3.048, all n P<0.01). After treatment, the HAMD score of the observation group[(10.72±1.53) points] was significantly lower than that of the control group[(12.93±1.84)points](n t=6.530, n P0.05).n Conclusion:The application of vortioxetine in the treatment of patients with first-episode depression can improve the cognitive function and clinical symptoms of patients, and can also reduce the biochemical indicators of patients.However, the therapeutic effect is similar to that of fluoxetine, but it has less adverse reactions, so it is worthy of promoting.
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