目的 探讨氟西汀不同用药周期对高血压伴焦虑抑郁患者血压、情绪状态及不良反应的影响.方法 按照随机数字表法将150例高血压伴焦虑抑郁患者分为A组、B组和C组各50例,A组盐酸氟西汀胶囊治疗8周+安慰剂治疗8周,B组盐酸氟西汀胶囊治疗12周+安慰剂治疗4周,C组盐酸氟西汀胶囊治疗16周,比较三组治疗效果和安全性.结果 三组患者治疗前SBP、DBP、NE、5-HT、SAS和SDS水平对比,P＞0.05;B、C两组患者治疗后SBP、DBP、SAS、SDS水平均显著低于A组(P＜0.05);B、C两组患者治疗后血浆NE水平显著低于A组,血浆5-HT水平显著高于A组(P＜0.05);C组患者治疗后血浆NE水平显著低于B组,血浆5-HT水平显著高于B组(P＜0.05);A、B两组患者治疗期间不良反应发生率均显著低于C组(P＜0.05).结论 氟西汀能够有效改善高血压伴焦虑抑郁患者的血压、心理状态和血浆NE、5-HT水平,选择12周为治疗周期效果确切,安全性更佳.

Objective To study the application of duloxetine in patients with functional dyspepsia (FD) complicated with anxiety and depression.Methods Ninety-six patients with FD complicated with anxiety and depression were equally divided into the control group and the treatment group according to the use of duloxetine.Patients in the control group were given routine treatment.On that basis,patients in the treatment group were treated with duloxetine and both groups were treated for 8 weeks.Relief of FD,depression,anxiety,improvement of quality of life and adverse reactions were compared between the two groups before treatment,at 2,4 and 8 weeks after the treatment.Results Two,4 and 8 weeks after treatment,the scores of adverse reactions in both groups decreased significantly,and there was significant difference between the two groups (P ＜0.05);2,4 and 8 weeks after treatment,the total effective rates of relieving FD in the treatment group (81％,88％,94％) were significantly higher than those in the control group (60％,67％,73％) (P ＜ 0.05);After treatment,the HAMD,HAMA and CGI-S1 scores of two groups were significantly decreased over time,and the decreasing ranges in treatment group were significantly higher than those in control group at 4 week and 8 weeks after treatment (P ＜0.05);8 weeks after treatment,the quality of life scores of the two groups increased significantly (P ＜ 0.05),and quality of life score in treatment group was significantly higher than that in control group (P ＜0.05);The total incidence of adverse reactions in the treatment group was 21％ while it was 19％ in the control group (P＞0.05).Conclusion Duloxetine is effective for treating FD with anxiety and depression.It can improve the quality of life of patients.And it is safe and effective,and worthy of clinical promotion.

Objective To explore the clinical efficacy of mirtazapine combined with repetitive transcranial magnetic stim‐ulation(rTMS) in elderly anxiety patients with sleep disorder .Methods Two hundred elderly cases with both anxiety and sleep disorder were divided into combination group (mirtazapine+rTMS) and control group(only mirtazapine) according to the order of admission ,each group had 100 cases .Two group received treatment for eight weeks and then clinical efficacies of two groups were compared .Results After treatment ,both the PSQI scale containing seven factors (sleep quality ,onset time ,sleep time ,sleep efficiency ,sleep disturbance ,hypnotic drug and daytime function) and PSQI scores(2.14 ± 2.39) in the combination group ,were significantly lower than those in the control group ,and all differences were statistically significant (P<0.05) .Af‐ter treatment ,the values of PSG sleep parameters(sleep latency ,REM latency ,total sleep time ,sleep efficiency ,awake times) in the combination group were significantly better than those in the control group ,with statistically significant differences (P<0.05) .Compared with control group ,the combination group held less SAS scores .Additionally ,the curative rate in the combi‐nation group(47% ) was obviously higher than that in the control group(32% ) .Conclusion The therapy of mirtazapine com‐bined with rTMS can more effectively improve clinical efficacy .

目的:探讨氟西汀与小剂量多虑平配伍治疗激越性抑郁的临床价值。方法:选择120例激越性抑郁患者,利用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA),激越分量表(BPRS),分别对入选患者在治疗前和治疗4周后进行评定,观察治疗效果及治疗期间不良反应。结果:治疗4周后的HAMD、HAMA和BPRS评分显著优于治疗前(P<0.05)。治疗4周后的激越因子评分与治疗前对照有显著性差异(P<0.05)。治疗4周后的胃肠不适症状与治疗前对照有显著性差异(P<0.05)。在4周治疗期间,出现口干20例,头晕1例,失眠3例,余无其他严重不良反应。结论:氟西汀与小剂量多虑平配伍治疗激越性抑郁,不但可增强氟西汀的抗抑郁作用,还可改善抑郁症伴发的激越性症状及胃肠不适等症状,且副作用较小。

Objective To analyze and evaluate the clinical efficacy and safety of venlafaxine hydrochloride sustained-release tablets in the treatment of depression.Methods 68patients with depression were randomly divided into the observation group(34cases,treated with venlafaxine hydrochloride sustained-release tablets)and the control group(34cases,treated with treated with amitriptyline hydrochloride).The curative effects of two groups were assessed by the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)before and after treatment.The adverse reaction of two medicines was evaluated by the Treatment Emergent Symptom Scale(TESS).Results The significant efficiency and total effective rate in the observation group were higher than these in the control group;The HAMD and HAMA scores of observation group were lower than these of control group,which had significant difference;The adverse reaction type and severity of observation group were lower than these of control group at the end of 2,4and 6weeks.Conclusion Venlafaxine hydrochloride sustained-release tablets has a exact curative effect on depression and a higher safety.

目的对比分析帕罗西汀联合阿立哌唑和单用帕罗西汀治疗青少年强迫症的疗效。方法将50例青少年学生强迫症患者随机分为帕罗西汀组和联合用药组,帕罗西汀组患者接受帕罗西汀治疗,联合用药组在帕罗西汀的基础上加用阿立哌唑进行治疗,疗程均为8周。治疗前、治疗4周和8周末分别进行耶鲁布朗强迫症量表(Y-BOCS)评分和汉密尔顿抑郁量表(HAMD)评分,停止治疗后采用治疗副反应量表(TESS)和不良反应发生率进行不良反应评定。结果治疗4周、8周末,联合用药组患者的Y-BOCS评分、HAMD评分均低于帕罗西汀组,差异有统计学意义(P<0.05)。治疗4周末两组疗效间差异无统计学意义(u=1.515,P>0.05);治疗8周末联合用药组的临床疗效高于帕罗西汀组,差异有统计学意义(u=3.209,P<0.05)。治疗结束时两组TESS评分和不良反应发生率间差异无统计学意义(P>0.05),对患者的学习无明显影响。结论帕罗西汀联合阿立哌唑治疗青少年学生强迫症的疗效优于单用帕罗西汀治疗的疗效,且不增加不良反应,对学生学习也无明显影响。