张海涛

摘要目的：對帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍的效果进行探讨。方法：选取2017年7月至2019年8月河北省唐山市玉田心理康复医院精神心理科收治的抑郁症并发睡眠障碍患者120例作为研究对象，随机分为观察组和对照组，每组60例。对照组患者采用口服帕罗西汀的方式治疗，观察组在对照组基础上联合小剂量奥氮平进行治疗，统计并比较2组患者不同时期汉密尔顿抑郁量表评分、各维度匹兹堡睡眠质量指数评分以及不良反应发生情况。结果：2组患者患者入院4周、12周、24周3个时段比较，观察组汉密尔顿抑郁量表评分均低于对照组，差异有统计学意义（P<005）;观察组患者匹兹堡睡眠质量指数各维度评分均高于对照组，差异有统计学意义（P<005）;观察组不良反应发生率低于对照组，差异有统计学意义（P<005）。结论：通过帕罗西汀联合小剂量奥氮平治疗抑郁症并发睡眠障碍效果显著高于单纯使用帕罗西汀治疗效果，可以有效缓解患者的抑郁症状，帮助患者调节负面心理，逐步恢复正常心理的同时提高患者的睡眠质量、睡眠时间、睡眠效率，减轻睡眠障碍，以此提高患者白天的活动力和活力，降低不良反应发生率，实现治疗有效性和安全性的双赢，在抑郁症并发睡眠障碍的治疗上具有临床应用价值与推广价值。

关键词帕罗西汀联合奥氮平;抑郁症;睡眠障碍

The Value of Paroxetine Combined with Olanzapine in the Treatment of Depression Complicated with Sleep Disorder

ZHANG Haitao

（Department of psychiatry，Yutian mental rehabilitation hospital，Tangshan 064100，China）

AbstractObjective：To investigate the effect of Paroxetine Combined with olanzapine in the treatment of depression complicated with sleep disorderMethods：From July 2017 to August 2019，120 patients with depression and sleep disorder were selectedPatients were randomly divided into observation group and control group，60 patients in each groupPatients in the control group were treated by oral paroxetinePatients in the observation group were treated with lowdose olanzapine on the basis of the control groupThe scores of Hamilton Depression Scale，Pittsburgh sleep quality index and adverse reactions in different periods of the two groups were counted and comparedResults：In the observation group，the scores of Hamilton Depression Scale were lower than those of the control group（P<005）; the scores of Pittsburgh sleep quality index in the observation group were higher than those of the control group（P<005）; the incidence of adverse reactions in the observation group was lower than that in the control group（P<005）Academic significance（P<005）Conclusion：The effect of Paroxetine Combined with olanzapine in the treatment of depression complicated with sleep disorders is significantly higher than that of paroxetine alone，which can effectively relieve the depression symptoms of patients，help patients to adjust their negative psychology，gradually recover their normal psychology，improve their sleep quality，sleep time，sleep efficiency，and reduce sleep disorders，so as to improve patients′ sleep quality It has clinical application value and promotion value in the treatment of depression complicated with sleep disorder.

KeywordsParoxetine combined with olanzapine; Depression; Sleep disorders

中图分类号：R74905文献标识码：Adoi：10.3969/j.issn.2095-7130.2020.06.009

据资料统计[13]，约83%的抑郁症患者同时伴有睡眠障碍症状，由此可以发现抑郁症与睡眠障碍有着密切的关联，因此睡眠障碍成为了临床中诊断抑郁症的重要参照依据之一[45]。抑郁症患者不仅要饱受精神与心理上的折磨，其并发睡眠障碍更对患者的健康、生活、工作、家庭带来了极大的困扰。尤其在社会发展的带动下，人们对生活有了更高的追求，无形中生活的压力也不断加大，导致抑郁症患者人数逐年上涨[6]。随着医疗领域对抑郁症的深入了解，开始将抑郁症治疗标靶锁定在抑郁症并发睡眠障碍上[78]。帕罗西汀是临床治疗抑郁症的主要药品，具有安全有效等特点，然而由于它起效慢以及对睡眠障碍无改善作用[9]，所以在治疗抑郁症上并不能称为完善疗法[1011]，而奥氮平作为一种治疗精神疾病的药物，具有改善患者睡眠的作用。……