上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (6): 746-.doi: 10.3969/j.issn.1674-8115.2012.06.012

• 论著（临床研究） • 上一篇    下一篇

文拉法辛治疗抑郁症伴焦虑症状的疗效及影响因素

黄 佳, 彭代辉, 苑成梅, 陈 俊, 王 勇, 李则挚, 洪 武, 吴志国, 易正辉, 胡莺燕, 曹 岚, 王凌霄, 方贻儒   

  1. 上海交通大学 医学院附属精神卫生中心心境障碍科, 上海 200030
  • 出版日期:2012-06-28 发布日期:2012-07-02
  • 通讯作者: 方贻儒, 电子信箱: yirufang@yahoo.cn。
  • 作者简介:黄 佳（1983—）, 女, 住院医师, 硕士；电子信箱: Kittyhj_2000@yahoo.cn。
  • 基金资助:

    国家自然科学基金（30971047）；国家高技术研究发展计划（“863”计划）（2006AA02Z430）；“十五”国家科技攻关计划（2004BA720A21-02）；上海市卫生局公共卫生优秀青年人才项目（08GWQ075）；上海市卫生局青年科研项目（2007Y14）；上海市科委“登山行动计划”（064119533, 2006-2008）

Clinical effects of venlafaxine in treatment of depressive disorder associated with anxiety and its impact factors

HUANG Jia, PENG Dai-hui, YUAN Cheng-mei, CHEN Jun, WANG Yong, LI Ze-zhi, HONG Wu, WU Zhi-guo, YI Zheng-hui, HU Ying-yan, CAO Lan, WANG Ling-xiao, FANG Yi-ru   

  1. Department of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
  • Online:2012-06-28 Published:2012-07-02
  • Supported by:

    National Natural Science Foundation of China, 30971047；National High Technology Research and Development Program of China, “863” Program, 2006AA02Z430, 2007Y14； National Key Technology R&D Program of China in “TenthFive Year Plan”, 2004BA720A21-02；Shanghai Municipal Health Bureau Foundation, 08GWQ075；Shanghai Science and Technology Committee Foundation, 064119533, 2006-2008

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摘要：

目的 探讨文拉法辛治疗抑郁症伴焦虑症状患者的疗效及影响因素。方法 采用汉密尔顿抑郁量表-17项（HAMD-17）和汉密尔顿焦虑量表（HAMA）筛选60例抑郁症伴焦虑症状患者，并随机进行国产文拉法辛缓释片治疗（博乐欣组，n=31）或进口文拉法辛胶囊治疗（怡诺思组，n=29），治疗8周，观察两组患者的疗效以及不同焦虑程度患者的疗效，分析抑郁和焦虑症状首次缓解时间的影响因素。结果 治疗3周后，博乐欣组和怡诺思组抑郁和焦虑症状得分均显著降低（P<0.05）；治疗8周后，两组治疗有效率分别为77.4%和65.5%。不同焦虑程度患者HAMD-17基线分差异有统计学意义（P<0.01），治疗3周后HAMD-17得分差异无统计学意义（P>0.05），各时段治疗有效率差异无统计学意义（P>0.05）。抑郁症状首次缓解时间与首次发作存在诱因和HAMD-17基线分呈显著负相关(P<0.05)，与HAMA基线分呈显著正相关（P<0.05）；而焦虑症状首次缓解时间与年龄呈显著正相关(P<0.05)，与首次发作存在诱因呈显著负相关(P<0.01)。结论 文拉法辛对抑郁症伴焦虑症状患者具有较好疗效。

关键词: 文拉法辛, 抑郁, 焦虑, 汉密尔顿抑郁量表-17项, 汉密尔顿焦虑量表

Abstract:

Objective To investigate the clinical effects of venlafaxine in the treatment of depressive disorder associated with anxiety, and explore its related factors. Methods Sixty patients with depressive disorder associated with anxiety were screened with Hamilton depression scale-17 (HAMD-17) and Hamilton anxiety scale (HAMA), and were randomly treated with domestic venlafaxine sustained-release tablets (Bolexin group, n=31) or imported venlafaxine capsules (Effexor group, n=29). Patients were followed up for 8 weeks, the clinical outcomes of patients in two groups and those of patients with different levels of anxiety were observed, and the related factors for time of initial relief of depression and anxiety symptoms were analysed. Results Three weeks after treatment, the scores of depression and anxiety symptoms in both Bolexin group and Effexor group were significantly improved (P<0.05), and the response rates of two groups were 77.4% and 65.5% respectively 8 weeks after treatment. There were significant differences in baseline HAMD-17 score among patients with different levels of anxiety (P<0.05), while there had been no significant difference in HAMD-17 score ever since 3 weeks after treatment （P>0.05）, and there was also no significant difference in response rate at each time point among them （P>0.05）. Time of initial relief of depression symptoms was significantly negatively related to the existence of induced factors for first episode and HAMD-17 baseline score (P<0.05), and was significantly positively related to HAMA baseline score (P<0.05). Time of first relief of anxiety symptoms was significantly positively related to age (P<0.05), and was significantly negatively related to the existence of induced factors for first episode (P<0.01). Conclusion Venlafaxine has favorable therapeutic effects on depressive disorder associated with anxiety.

Key words: venlafaxine, depression, anxiety, Hamilton depression scale-17, Hamilton anxiety scale