摘要
目的：对比探讨奥氮平与氟西汀联合治疗及单独使用氟西汀治疗难治性抑郁的疗效差异，为临床治疗提供参考。方法：将2012年11月~2014年1月我院确诊收治的50例难治性抑郁症患者按治疗方法的不同平均分为对照组与实验组，对照组独使用氟西汀治疗（8周/疗程，30mg/天，早餐后服），实验组采取奥氮平与氟西汀联合治疗（8周/疗程、奥氮平5mg/天，睡前口服、氟西汀30mg/天，早餐后服），利用汉密尔顿抑郁量表（HADM）在治疗前后对患者进行情况评分、疗效评价。结果：比较分析治疗前后对照组与实验组患者情况，两组患者均有所好转，与治疗前相比， HADM评分均有所下降。治疗后1、2、4、6、8周对患者进行的HADM评分显示，实验组低于对照组，总有效率对照组为56％低于实验组的84％，P＜0.05，差异有统计学意义。相关不良反应的发生率实验组为44％，对照组36％，P＜0.05，差异有统计学意义。结论：奥氮平与氟西汀联合治疗难治性抑郁患者比单独使用氟西汀治疗的临床疗效更好，不良反应发生率较低，在氟西汀单独治疗但效果欠佳的情况下，可以采用奥氮平与氟西汀联合治疗难治性抑郁患者的方法。
Abstract
objective comparison of olanzapine and fluoxetine combination therapy and single use the curative effect of fluoxetine in the treatment of refrac-tory depression, provide reference for clinical treatment. Method in November 2012 to January 2012 were confirmed in our 50 cases of patients with treat-ment- resistant depression according to the different average divided into control group and treatment group, control group treated with fluoxetine alone (/ 8 weeks treatment, 30 mg/day, after breakfast served), the experimental group treated with olanzapine and fluoxetine combined (8 weeks treatment, olanzapine 5 mg/day, before going to bed, oral fluoxetine 30 mg/day, after breakfast served), using the Hamilton depression rating scale (HADM) before and after the treatment of patients with score, curative effect evaluation. Results compared before and after treatment in patients with the control group and experimental group, two groups of patients were improved, compared with before treatment, HADM scores were decreased. After treatment 1, 2, 4, 6, 8 weeks HADM score of patients, according to the experimental group is lower than the control group, the total effective rate in the control group was 56%less than 84%of the experimental group, P<0.05, the difference was statistical y significant. Related to the incidence of adverse reactions to the experimental group was 44%, 36%, the control group (P<0.05, the difference was statistical y significant. Conclusion olanzapine and fluoxetine combination therapy in patients with treatment- resistant depression than used alone the clinical curative effect of fluoxetine treatment is better, the low incidence of adverse reactions, the ef ect of fluoxetine treatment alone but poor, can use of olanzapine and fluoxetine combined method for the treatment of patients with treatment- resistant depression.
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