专家讲堂:徐亚辉教授:四种抗抑郁药物治疗慢性失眠症疗效及安全性研究

2022-03-11 徐亚辉 “神经时讯”公众号

新乡医学院第二附属医院 徐亚辉

新乡医学院第二附属医院 徐亚辉

目的

探讨四种抗抑郁药物对慢性失眠症患者睡眠质量、日间疲劳与嗜睡程度、焦虑与抑郁症状、血压、血糖、心电图的影响,以期阐明四种药物治疗慢性失眠症的疗效及安全性。

方法

招募慢性失眠症患者120例,分为阿戈美拉汀组、曲唑酮组、氟伏沙明组、米氮平组,每组30例。采用匹兹堡睡眠质量指数量表(PSQI)、失眠严重指数量表(ISI)评估睡眠质量,Flinders疲劳量表(FFS)、Epworth嗜睡量表(ESS)评估日间疲乏体验及嗜睡程度,汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评估焦虑及抑郁症状。监测血压、血糖、心电图评估药物安全性。治疗4周后复测上述指标,比较治疗前与治疗4周后上述指标的差异。

结果

1. 四组在性别、年龄、受教育程度等一般人口学资料以及PSQI、ISI、FFS、ESS、HAMA、HAMD、收缩压、舒张压、血糖、心率、PR间期、QRS波宽、QTc间期治疗前基线水平的差异均无统计学意义。

2. 与治疗前相比,治疗4周后四组PSQI评分、ISI评分、FFS评分均降低,ESS评分均升高,阿戈美拉汀组、氟伏沙明组较曲唑酮组、米氮平组ESS评分升高。

3. 与治疗前相比,治疗4周后四组HAMA评分、HAMD评分均降低;曲唑酮组较米氮平组HAMA评分降低;米氮平组较曲唑酮组、氟伏沙明组HAMD评分降低,阿戈美拉汀组较曲唑酮组HAMD评分降低。

4. 与治疗前相比,治疗4周后四组收缩压、舒张压均有不同程度的降低,血糖、心率、PR间期、QRS波宽、QTc间期差异均无统计学意义。

结论

1. 四种药物均能改善慢性失眠症患者睡眠质量、失眠严重程度、日间疲乏体验及焦虑抑郁症状,且均能增加日间嗜睡程度。

2. 曲唑酮改善慢性失眠症患者的焦虑症状疗效优于米氮平。米氮平改善其抑郁症状疗效优于曲唑酮、氟伏沙明,阿戈美拉汀疗效优于曲唑酮。阿戈美拉汀、氟伏沙明较曲唑酮、米氮平更易导致日间嗜睡。

3. 四种药物对收缩压、舒张压均有降低作用,对血糖、心电图无明显影响。

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    2022-11-01 wetgdt
  2. [GetPortalCommentsPageByObjectIdResponse(id=1722543, encodeId=73fb1e2254397, content=<a href='/topic/show?id=7ff5549865a' target=_blank style='color:#2F92EE;'>#抑郁药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54986, encryptionId=7ff5549865a, topicName=抑郁药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78fa33270286, createdName=wetgdt, createdTime=Tue Nov 01 13:44:00 CST 2022, time=2022-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1242939, encodeId=8bed1242939e3, content=所以推荐哪一种?, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da6b8306175, createdName=ms2000002125233860, createdTime=Sat Sep 03 11:16:00 CST 2022, time=2022-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299397, encodeId=002f129939e08, content=<a href='/topic/show?id=59d64429252' target=_blank style='color:#2F92EE;'>#失眠症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44292, encryptionId=59d64429252, topicName=失眠症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4a4d285, createdName=日月, createdTime=Fri Mar 11 04:44:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446708, encodeId=a5621446e0866, content=<a href='/topic/show?id=38bf553405a' target=_blank style='color:#2F92EE;'>#抗抑郁药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55340, encryptionId=38bf553405a, topicName=抗抑郁药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4bd5278649, createdName=huhuaidong389, createdTime=Fri Mar 11 04:44:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492281, encodeId=e23d14922815e, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Fri Mar 11 04:44:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-09-03 ms2000002125233860

    所以推荐哪一种?

    0

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    2022-03-11 日月
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