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目的探讨文拉法辛合并认知心理治疗对难治性抑郁症的治疗效果,为临床难治性抑郁症治疗提供有效依据。方法选取2013年2月—2017年2月110例难治性抑郁症患者作为研究对象,依据随机数字表法分为对照组和联合组,每组55例。其中,对照组采用文拉法辛进行治疗,联合组采用文拉法辛联合认知心理治疗。比较两组治疗总有效率,患者用药依从性评分;治疗前、后患者17项汉密尔顿抑郁量表评分、14项汉密尔顿焦虑量表评分、SF-36生活质量评分及用药不良反应发生率。结果联合组难治性抑郁症治疗总有效率(96.36%)高于对照组(76.36%),差异有统计学意义(P<0.05);治疗前,联合组与对照组17项汉密尔顿抑郁量表评分[(27.34±2.25)分vs.(27.25±2.21)分]、14项汉密尔顿焦虑量表评分[(25.54±3.56)分vs.(25.55±3.71)分]、SF-36生活质量评分[(53.73±5.65)分vs.(52.02±5.66)分]相近,差异无统计学意义(P>0.05);治疗后,联合组17项汉密尔顿抑郁量表评分(12.78±0.32)分及14项汉密尔顿焦虑量表评分(11.21±0.51)分低于对照组,SF-36生活质量评分(94.25±6.61)分高于对照组,差异有统计学意义(P<0.05);两组均无明显用药不良反应发生。结论文拉法辛合并认知心理治疗对难治性抑郁症的治疗效果确切,可弥补单一用药的缺陷,提高患者治疗依从性和治疗效果,减轻患者焦虑抑郁症状,提高其生活质量。
Objective To investigate the therapeutic effect of venlafaxine combined with cognitive psychotherapy on refractory depression and provide an effective basis for the treatment of clinical refractory depression. Methods Totally 110 patients with refractory depression from February 2013 to February 2017 were divided into control group and combination group according to random number table method, with 55 cases in each group. Among them, the control group was treated with venlafaxine, combined with venlafaxine combined cognitive psychotherapy. The total effective rate of the two groups was compared. The medication compliance scores of the two groups were compared. The 17 Hamilton Depression Scale scores, 14 Hamilton Anxiety Scale scores, SF-36 quality of life scores and adverse drug reactions were recorded before and after treatment. Results The total effective rate of treatment of refractory depression in the combination group was 96.36%, which was significantly higher than that in the control group (76.36%) (P <0.05). Before treatment, the 17 Hamilton Depression Rating Scale Score of [(27.34 ± 2.25) vs (27.25 ± 2.21)], 14 items of Hamilton Anxiety Scale [(25.54 ± 3.56) vs (25.55 ± 3.71)], SF-36 quality of life score 53.73 ± 5.65) and (52.02 ± 5.66) points respectively, there was no significant difference between the two groups (P> 0.05). After treatment, 17 Hamilton depression scale scores (12.78 ± 0.32) and 14 Hamilton anxiety The score of the scale (11.21 ± 0.51) was lower than that of the control group, SF-36 quality of life score (94.25 ± 6.61) was higher than the control group, the difference was statistically significant (P <0.05) occur. Conclusions Venlafaxine combined with cognitive psychotherapy has the exact effect on the treatment of refractory depression. It can make up for the defects of single drug use, improve the treatment compliance and treatment effect, alleviate the anxiety and depression symptoms and improve the quality of life.