王步军 江天惠

[摘要] 目的 探讨奥氮平联合氟西汀在抑郁症患者中的治疗效果，并观察其安全性。方法 回顾性分析该院2015年1月—2017年12月收治的84例抑郁症患者的临床资料，其中40例采用氟西汀治疗，为对照组。44例采用奥氮平联合小剂量氟西汀治疗，为观察组。比较两组的临床疗效、抑郁评分变化以及药物的不良反应。 结果 观察组的总有效率81.82%高于对照组50.00%，差异有统计学意义（χ2=8.167，P<0.05）。观察组治疗后2周、4周、8周的HAMD评分（19.52±5.23）分、（15.47±6.16）分、（12.37±5.34）分均低于对照组的（23.48±5.71）分、（21.68±6.23）分、（17.37±5.22）分，差异有统计学意义（t=9.551、4.590、4.332，P<0.05）。观察组的不良反应36.36%少于对照组的72.50%，差异有统计学意义（χ2=9.595，P<0.05）。 结论 奥氮平联合氟西汀能够显著提高抑郁症的治疗效果，而且起效快，不良反应少，安全性高。

[关键词] 奥氮平;氟西汀;抑郁症;临床疗效;安全性

[中图分类号] R749.4          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0118-03

Clinical Efficacy and Safety Analysis of Olanzapine Combined with Fluoxetine in the Treatment of Depression

WANG Bu-jun， JIANG Tian-hui

Department of Psychiatry， Zhangjiagang Fourth Peoples Hospital， Zhangjiagang， Jiangsu Province， 215600 China

[Abstract] Objective To investigate the therapeutic effect of olanzapine combined with fluoxetine in patients with depression and to observe its safety. Methods The clinical data of 84 patients with depression who were admitted to the hospital between January 2015 and December 2017 were retrospectively analyzed. Of them， 40 patients were treated with fluoxetine as control group. 44 patients were treated with olanzapine combined with a small dose of fluoxetine as the observation group. The clinical efficacy， changes in depression score， and adverse drug reactions were compared between the two groups. Results The total effective rate of the observation group was 81.82% higher than that of the control group 50.00%， and the difference was statistically significant （χ2=8.167， P<0.05）. The HAMD scores of the observation group at 2 weeks， 4 weeks， and 8 weeks after treatment were （19.52±5.23）points， （15.47±6.16）points， and （12.37±5.34）points， which were lower than the control group's （23.48±5.71）points， （21.68±6.23）points， and （17.37±5.22）points. The difference was statistically significant （t=9.511， 4.590， 4.332， P<0.05）. The adverse reactions in the observation group were 36.36% less than the 72.5% in the control group， and the difference was statistically significant （χ2=9.595， P<0.05）. Conclusion Olanzapine combined with fluoxetine can significantly improve the therapeutic effect of depression， and has rapid onset， less adverse reactions， and high safety.

[Key words] Olanzapine; Fluoxetine; Depression; Clinical efficacy; Safety

抑郁症是一种比较常见的精神心理障碍疾病，以持久性情绪低落为主要特征，部分患者可出现幻觉和妄想[1]。抑郁症的病程较长，对人的生活和社会功能都会产生较大的影响。随着现代工作压力的增大和生活节奏的加快，抑郁症的发病率有逐渐上升的趋势。据相关报道[2]，我国抑郁症的发病率为0.12～0.13%。近年来，由抑郁症导致的自杀现象逐渐在增多，抑郁症也越来越起社会上的关注。药物治疗仍然是目前治疗抑郁症的主要方法，但单一药物的起效时间较长，而且有一些该病的患者不能收到良好的治療效果。有研究显示[3]，氟西汀联合奥氮平在治疗抑郁症方面的疗效满意。现回顾性分析该院2015年1月—2017年12月收治的84例抑郁症患者的临床资料，观察奥氮平联合氟西汀治疗的临床疗效及安全性，现报道如下。

1  资料与方法

1.1  一般资料

回顾性分析84例抑郁症患者的临床资料，纳入标准：①均符合CCMD-3中抑郁症的诊断标准;②均签署知情同意书;③年龄≥18岁;④实验室检查、心电图、脑电图均正常;⑤既往均无抑郁症病史;⑥有阅读和应答能力。……