摘要
目的:探讨银杏叶提取物合并帕罗西汀对抑郁症治疗的增效作用及其对躯体症状的改善作用。方法:选择2003-01/2004-04于解放军第四军医大学唐都医院心理门诊就诊的抑郁症患者89例,按就诊及确诊顺序编号,单号为观察组(n=45),双号为对照组(n=44)。对照组给予帕罗西汀治疗,剂量20mg,1次/早,口服。观察组除给予20mg帕罗西汀治疗外,同时合并银杏叶片19.2mg,3次/d,口服。疗程为6周。采用汉密顿抑郁量表评定患者的抑郁程度,包括24项症状,归纳为7个因子,每个因子反映某一方面症状的严重程度。大部分项目采用0～4的5级评分,少数项目采用0～2的3级评分,总分=各项目评分之和,因子分=该因子各项目评分总和/该因子项目数。经过治疗,总分降到7分以下为疗效显著,降为8～10分为好转。分别于治疗前及治疗第6周后对两组患者抑郁程度进行评定,一次评定15～20min。组间比较采用t检验。结果:纳入观察组45例,对照组44例,分别脱落5、6例,脱落病例均为不能及时复查和进行心理检测者。剩余观察组40例,对照组38例患者均完成定期的复诊和心理检测,量表检测经检验均符合要求,进入结果分析。①两组治疗前后汉密顿抑郁量表总分结果:两组治疗第6周后汉密顿抑郁量表总分均明显低于治疗前(P<0.01)。治疗第6周后观察组汉密顿抑郁量表总分明显低于对照组(P<0.05)。②两组治疗前后汉密顿抑郁量表各因子分结果:观察组治疗第6周后汉密顿抑郁量表各因子分均明显低于治疗前(P<0.01～0.05),对照组治疗第6周后焦虑/躯体化、体质量、认知障碍、日夜变化为低于治疗前(P<0.01～0.05),迟滞、睡眠障碍、绝望感因子差异不显著。治疗第6周后对照组焦虑/躯体化、体质量、迟滞、睡眠障碍、绝望感明显高于观察组(P<0.01～0.05)。③不良事件及副反应发生情况:两组患者在治疗过程中均未发现明显的副反应及不良事件。观察组4例(占10%)出现轻度恶心、腹胀等胃肠道反应;2例(占5%)出现头晕;3例(7.5%)出现轻度失眠。对照组出现恶心、腹胀,头晕及轻度失眠的例数及所占比例分别为8例(21.1%)、4例(10.5%)、2例(5.3%)。这些副反应均在1周左右缓解或消失,未给予任何特殊处理。结论:银杏叶片合并帕罗西汀治疗抑郁症疗效优于单用帕罗西汀,能有效改善抑郁及相关躯体症状,且耐受性较好。
AIM： To investigate the therapeutic effects of ginkgo leaves tablets integrated with paroxetine on depression, and the ameliorative function on body symptom. METHODS：Eighty-nine depression patients, who were treated at the psycho out-patient clinic of Tangdu Hospital, Fourth Military Medical University of Chinese PLA from January 2003 to April 2004. They were numbered by the order of visiting and diagnosing, the patients with single numbers were considered as study group （n=45） and those with even numbers were as control group （n=44）. The patients in the control group were treated with 20 mg paroxetine, once a day in the morning, taking orally. Those in the study group were treated with 20 mg paroxetine integrated with 19.2 mg ginkgo leaves tablets, three times a day, taking orally. The progress was 6 weeks. Depression level of patients was evaluated with Hamilton depression rating scale （HAMD）, including 24 items and 7 dimensions, every dimension reflecting one symptom. Most items adopted 5 grades score way with 0-4 scores. A few items adopted 3 grades score way with 0-2 scores. The result analysis： the total score was＇equal to the sum of each item score. The factor score equals to all items＇ total score of the factor / the number of items of the factor. After treatment, the total score dropping to below 7 points meant significant therapeutic effect, dropping to 8-10 points meant improving. Depression level of patients in the two groups was assessed before treatment and after treatment for 6 weeks, once for 15-20 minutes. Comparison of the two groups was performed with t test. RESULTS：Five and six patients in the study group with 45 patients and control group with 44 patients were dropped, respectively, because they could not conduct reviews and detection. Forty patients in the study group and 38 patients in the control group were all conducted regular reviews and psychological detection. The results of scale were all accorded with the criteria, and they were involved in the result analysis. ① General scores of HAMD before and after treatment in the two groups： After therapy for 6 weeks, the general scores of HAMD was lower significantly than before therapy （P 〈 0.01 ）. After therapy for 6 weeks, the general scores of HAMD in the study group was lower significantly than that in the control group （P 〈 0.05）. ②Every factor score of HAMD before and after therapy in the two groups： Every factor score of HAMD in the study group after therapy for 6 weeks Was lower significantly than that before therapy （P 〈 0.01-0.05 ）. After treatment for 6 weeks, scores on anxiety/somatization, body mass, cognitive handicap and changes of day and night in the control group were lower than those before therapy （P 〈 0.01-0.05 ）. Scores on hysteresis, dyssomnia and feeling of despair had insignificant difference. After therapy for 6 weeks, scores on anxiety/somatization, body mass, hysteresis, dyssomnia and feeling of despair were higher significantly than those in the study group （P 〈 0.01-0.05 ）. ③ Occurrence of adverse events and side effects： There was no significant adverse event and side effect in treatment of the patients of the two groups. In the study group gastrointestinal tract reaction, such as light nausea and abdominal distention, etc. appeared in the four patients （10%）; Two patients with dizziness （5%）; Three patients with light sleeplessness （7.5%）. In the control group, the proportion of patients with nausea, abdominal distention, dizziness and light sleeplessness was 8 cases （21.1%）, 4 cases （10.5%） and 2 cases （5.3%）, respectively. These side effects should relieve or disappear around 1 week, and no special disposal was done. CONCLUSION：Therapeutic effects of the ginkgo leaves tablets integrated with paroxetine on the treatment of depression are better than only using paroxetine, which can ameliorate effectively depression and relative body symptom and toleration is perfect.
出处
《中国临床康复》
CSCD
北大核心
2006年第2期43-45,共3页
Chinese Journal of Clinical Rehabilitation
基金
陕西省科学技术研究发展计划资助项目(2003K10G90)~~
作者简介
郭克锋，男，1956年生，河南省唐河县人，汉族，1983年第四军医大学毕业，学士，副教授，副主任医师，主要从事脑血管病、临床心理疾病的诊治研究。tdgkf@tom．com。
