[摘要] 目的 探讨齐拉西酮联合艾司西酞普兰治疗难治性抑郁症（TRD）的效果与安全性。 方法 将60例TRD患者随机分为研究组（齐拉西酮联合艾司西酞普兰）和对照组（单用艾司西酞普兰），每组各30例，疗程8周。治疗前及治疗后第2、4、6、8周分别采用汉密尔顿抑郁量表（HAMD）、不良反应量表（TESS）评定疗效和不良反应。 结果 研究组总有效率为70.0%，对照组总有效率为43.3%，差异有统计学意义（χ2=4.34，P<0.05）。治疗2周末研究组HAMD评分较对照组明显下降，差异有统计学意义（P<０.05）。治疗8周后，两组间HAMD比较差异有统计学意义（P<0.01），两组间TESS评分差异无统计学意义（P>0.05）。 结论 齐拉西酮联合艾司西酞普兰治疗TRD的效果较佳，安全性高。

[关键词] 齐拉西酮；艾司西酞普兰；难治性抑郁症；疗效

[中图分类号] R749.4[文献标识码] A[文章编号] 1674-4721（2014）05（a）-0038-03

Effect observation of escitalopram combination with ziprasidone in the treatment of treatment-resistant depression

LI Xin-fen

Xinyang Mental Hospital of Henan Province,Xinyang 464000,China

[Abstract] Objective To compare the curative effect and safety of ziprasidone and esicitalopram in the treatment of treatment-resistant depression. Methods 60 patients with treatment-resistant depression were divided into study group (escitalopram combination with ziprasidone) and control group (alone esicitalopram),each group of 30 cases,the course of 8 weeks.Hamilton depressive scale (HAMD) and treatment emergent symptom scale (TESS) were used to evaluate the efficacy and adverse reactions before and after treatment 2,4,6,8 weeks. Results The total effective rates of study group and control group were 70.0% and 43.3% respectively,there was significant difference between two groups (χ2=4.34,P<0.05).The HAMD scores in study group was significantly lower than that of the control group after 2 weeks.After 8 weeks,the HAMD in the two groups,the difference was statistically significant (P<0.01),the TESS scores in the two groups,there was no statistically significant difference (P>0.05). Conclusion Ziprasidone combined with esicitalopram in the treatment of treatment-resistant depression has better efficacy and high safety.

[Key words] Ziprasidone;Esicitalopram;Treatment-resistant depression;Efficacy

艾司西酞普兰治疗抑郁症有较好的效果，但仍有部分难治性患者不能取得满意的效果。有文献[1]报道，齐拉西酮能提高难治性抑郁症（treatment-resistant depression，TRD）的临床疗效。本研究采用齐拉西酮联合艾司西酞普兰治疗TRD取得较好的效果。

1 资料与方法

1.1 一般资料

选取2012年1～12月在本院门诊及住院的60例TRD患者为研究对象，所有患者均符合中国精神障碍分类与诊断标准第3版抑郁发作的诊断标准；年龄18～60岁，病程＞3年；汉密尔顿抑郁量表（HAMD）前17项总分≥18分[2]（＞20分为抑郁状态，＜7分为无抑郁状态）；停药>3周作为清洗期。符合TRD的诊断标准；曾使用＞2种作用机制不同的抗抑郁药足量、足疗程治疗后仍无效的抑郁症患者。排除有严重躯体疾病、有精神活性物质滥用或依赖、妊娠及哺乳期妇女、有严重精神病性症状和自杀倾向者。……