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目的评价艾司西酞普兰治疗糖尿病患者焦虑抑郁的效果和对血糖的影响。方法对72例符合糖尿病诊断标准且伴焦虑、抑郁者,进行6周的随机对照研究,被试分为研究组和对照组各36例。对照组在常规的糖尿病治疗基础上,给予单纯的心理治疗;研究组在上述基础上,给予艾司西酞普兰5～20mg/d,采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)进行疗效评定,用副反应量表(TESS)评定不良反应。糖化血红蛋白(GHb)用于血糖控制的监测。结果①研究组治疗前后HAMD及HAMA评分比较有显著性差异(t=4.85,5.69;P<0.01);②两组间从治疗第2周末起,各时点HAMD及HAMA评分有显著性差异(t=4.67,5.01;P<0.01)、TESS评分无显著性差异(t=3.68,P>0.05);③研究组GHb水平改善优于对照组,但无显著性差异。结论艾司西酞普兰能有效缓解糖尿病患者的抑郁、焦虑症状,有利于血糖的控制,药物相互作用少,耐受性好,安全性高,起效快。
Objective To evaluate the effect of escitalopram on anxiety and depression in diabetic patients and its effect on blood glucose. Methods A total of 72 patients with anxiety and depression who met the diagnostic criteria of diabetes were randomly divided into study group (36 cases) and control group (36 cases). The control group received simple psychotherapy based on routine diabetes treatment. The study group was given escitalopram 5-20mg / d on the basis of the above, using Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Scale (HAMA ) For efficacy evaluation, adverse reaction was assessed by TESS. Glycated hemoglobin (GHb) is used to monitor glycemic control. Results ① The scores of HAMD and HAMA in study group before and after treatment were significantly different (t = 4.85,5.69; P <0.01); ②The HAMD and HAMA scores were significantly different at the two groups from the second week after treatment t = 4.67, 5.01; P <0.01). There was no significant difference in TESS score between the two groups (t = 3.68, P> 0.05). Conclusion Escitalopram can effectively relieve the symptoms of depression and anxiety in diabetic patients, which is good for the control of blood glucose, less drug interactions, good tolerability, high safety and fast onset of action.