艾司西酞普兰联合小剂量奥氮平治疗重度抑郁症患者的疗效观察

Observations on the Efficacy of Escitalopram Combined with Low-Dose Olanzapine in the Treatment of Severe Depression Patients

摘要: 目的：探究艾司西酞普兰联合小剂量奥氮平治疗重度抑郁症患者的疗效。方法：将重度抑郁症患者随机分为对照组和试验组。对照组给予艾司西酞普兰片，起始剂量5 mg/d，依据病情1周内逐渐加量，直至达10~20 mg/d，口服，连续治疗8周；试验组在对照组的基础上给予奥氮平片2.5 mg/d，口服，视患者的病情调整用药量，保证剂量在5.0~10.0 mg/d，连续治疗8周。用汉密尔顿抑郁量表(HAMD)、Snaith快感缺失量表评估2组在第1、4、8周的临床症状与疗效及药物不良反应发生情况。结果：试验组和对照组各54例。试验组和对照组治疗总有效率分别为40.7%和18.5%，差异有统计学意义(P < 0.05)。与治疗前比，治疗后1周、4周及8周后两组的HAMD总评分均随治疗时间延长呈下降趋势(P < 0.05)。治疗后1周、4周及8周后两组的SHAPS总评分均随治疗时间延长呈下降趋势(P < 0.05)。两种药物联合应用较单种抗抑郁药物应用在治疗总有效率上存在统计学差异(P < 0.05)。两组治疗期间不良反应发生率比较无统计学差异(P > 0.05)。结论：奥氮平联合艾司西酞普兰治疗重度抑郁症可明显减轻其抑郁核心症状，提高认知功能与生活质量，安全性好。

Abstract: Objective: To investigate the efficacy of the combination of escitalopram and low-dose aripiprazole in the treatment of patients with major depression. Methods: Patients with major depression were randomly assigned to a control group and an experimental group. The control group was adminis-tered escitalopram tablets at an initial dose of 5 mg/day, gradually increased within one week, up to 10~20 mg/day orally, for a continuous treatment period of 8 weeks. The experimental group, in addition to the treatment in the control group, was administered aripiprazole tablets at a dose of 2.5 mg/day orally, with adjustments in dosage based on the patient’s condition to maintain a dose of 5.0~10.0 mg/day, for a continuous treatment period of 8 weeks. Clinical symptoms, efficacy, and occurrence of adverse drug reactions in both groups at weeks 1, 4, and 8 were assessed using the Hamilton Depression Rating Scale (HAMD) and the Snaith-Hamilton Pleasure Scale (SHAPS). Re-sults: There were 54 cases in both the experimental group and the control group. The total effective rates in the experimental and control groups were 40.7% and 18.5%, respectively, with a statisti-cally significant difference (P < 0.05). The HAMD total scores in both groups showed a decreasing trend with the extension of the treatment time at weeks 1, 4, and 8 after treatment compared to before treatment (P < 0.05). The SHAPS total scores in both groups also exhibited a decreasing trend with the extension of the treatment time at weeks 1, 4, and 8 after treatment (P < 0.05). There was a statistically significant difference in the total effective rate between the combination of the two drugs and the use of a single antidepressant (P < 0.05). The incidence of adverse reactions during the treatment period in both groups showed no statistically significant difference (P > 0.05). Conclusion: The combination of aripiprazole and escitalopram in the treatment of major depression can significantly alleviate core depressive symptoms, improve cognitive function, and enhance the quality of life with good safety.