朱永 刘颖

[摘要] 目的 探讨度洛西汀与舍曲林治疗抑郁症的临床疗效及不良反应情况。 方法 选择2019年1—12月在我院治疗的抑郁症患者60例为研究对象，随机分为A组与B组，每组各30例。A组采用盐酸度洛西汀肠溶片口服治疗，B组采用盐酸舍曲林分散片口服治疗。比较治疗后两组汉密顿抑郁量表（HAMD）-17评分，临床疗效及不良反应发生情况。 结果 A组治疗后HAMD-17为（8.5±1.3）分，B组为（8.2±1.5）分，均显著低于治疗前，差异有统计学意义（P<0.05）;治疗后两组间HAMD-17评分比较，差异无统计学意义（P>0.05）。A组总有效率为70.0%，B组总有效率为73.3%，两组总有效率比较，差异无统计学意义（P>0.05）。A组不良反应总发生率低于B组，差异有统计学意义（P<0.05）。 结论 度洛西汀与舍曲林治疗抑郁症均有较好的临床疗效，可显著改善患者抑郁情况及相关症状，但度洛西汀的不良反应总发生率更低，临床上应根据患者具体情况选择最佳的治疗方案。

[关键词] 度洛西汀;舍曲林;抑郁症;安全性

[Abstract] Objective To investigate the clinical efficacy and adverse reactions of duloxetine and sertraline in the treatment of depression. Methods Sixty patients with depression treated in our hospital from January to December 2019 were selected as the research objects. They were randomly divided into group A and group B with 30 cases in each group. Group A was treated with duloxetine hydrochloride enteric-coated tablets， and group B was treated with sertraline hydrochloride dispersible tablets. The Hamilton depression scale （HAMD）-17 scores， clinical efficacy， and adverse reactions were compared between the two groups after treatment. Results The scores of HAMD-17 after treatment in group A（8.5±1.3） points and group B（8.2±1.5） points were significantly lower than those before treatment， and the differences were statistically significant（P<0.05）. After treatment， there was no significant difference in the HAMD-17 score between the two groups（P>0.05）. The total effective rate of group A and group B were 70.0% and 73.3% respectively. The difference between the two groups was not significant（P>0.05）. The total incidence of adverse reactions in group A was lower than group B， and the difference was statistically significant（P<0.05）. Conclusion Both duloxetine and sertraline have sound clinical effects in the treatment of depression， which can significantly improve the depression and related symptoms of patients. Still， the total incidence of adverse reactions of duloxetine is lower， and the best treatment plan should be chosen based on the specific conditions of patients in clinical practice.

[Key words] Duloxetine; Sertraline; Depression; Safety

抑郁癥是一个全球性的精神危机，随着社会发展，生存竞争加剧、外部内部压力加大，很多人处于精神亚健康状态，其中抑郁症最为普遍。抑郁症是一种常见的心境障碍，可以由各种原因引起，以显著而持久的心境低落为主要临床特征。抑郁症对患者既有心理上的影响，也有生理上的影响，可影响中枢神经系统、睡眠-觉醒节律、应激系统、内分泌系统等，药物是治疗抑郁症的主要方法。度洛西汀是一种选择性的5-羟色胺（5-hydroxytryptamine，5-HT）和去甲肾上腺素（Norepinephrine，NE）再摄取抑制药物，临床上可用于抑郁症的治疗，其主要的不良反应包括心血管系统、中枢神经系统、内分泌系统、消化系统不良反应及过敏反应等[1-2]。舍曲林是临床治疗抑郁症相关症状的常用药物，包括伴随焦虑、有无躁狂史的抑郁症，其常见的不良反应包括代谢及营养、消化系统、神经系统及生殖系统不良反应等[3-4]。本研……