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目的观察艾司唑仑与盐酸帕罗西汀对老年溃疡性结肠炎合并抑郁的临床疗效。方法 62例溃疡性结肠炎合并抑郁的患者随机分为试验组和对照组,每组31例。对照组服用艾司唑仑,每次1 mg,每天3次;试验组用盐酸帕罗西汀治疗,初始剂量为10 mg·d~(-1),每天1次,治疗3 d后将剂量增加至20 mg·d~(-1),每天1次。2组患者均治疗2个月。比较2组患者治疗前后内镜指数(EI)评分、活动指数(CAI)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分的变化。评价2组患者的临床疗效和药物不良反应发生情况。结果治疗后,试验组患者的EI评分为(3.98±0.63)分,CAI评分为(1.62±0.36)分,对照组的EI评分(4.02±0.54)分,CAI评分(1.56±0.35)分,2组差异无统计学意义(P>0.05)。治疗后,试验组的HAMD评分为(14.25±2.38)分,HAMA评分为(11.33±2.56)分,对照组的HAMD评分为(17.24±2.45)分,HAMA评分为(15.19±2.72)分(P<0.05)。试验组的总有效率为90.32%(28/31例),对照组的总有效率为83.87%(26/31例),差异无统计学意义(P>0.05)。试验组出现嗜睡2例,头晕、恶心各3例,对照组出现上肢震颤1例,头晕3例,恶心2例。试验组的药物不良反应发生率为25.81%(8/31例),对照组为19.35%(6/31例),差异无统计学意义(P>0.05)。结论艾司唑仑与盐酸帕罗西汀对溃疡性结肠炎合并抑郁的老年患者的临床效果和安全性相当,但盐酸帕罗西汀改善患者焦虑、抑郁情绪效果更优。
Objective To observe the clinical efficacy of estazolam and paroxetine in the treatment of senile ulcerative colitis with depression. Methods Sixty-two patients with ulcerative colitis and depression were randomly divided into experimental group and control group, with 31 cases in each group. The control group took estazolam once a day for 3 times. The experimental group was treated with paroxetine hydrochloride at an initial dose of 10 mg · d -1 once a day. After 3 days of treatment, the dose was increased to 20 mg · d ~ (-1) once daily. Two groups of patients were treated for 2 months. The changes of endoscopic index (EI), activity index (CAI), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores before and after treatment were compared between the two groups. Evaluation of two groups of patients with clinical efficacy and adverse drug reactions. Results After the treatment, the EI scores of the test group were (3.98 ± 0.63) points, the CAI score was (1.62 ± 0.36) points, the control group was score of EI (4.02 ± 0.54), CAI score (1.56 ± 0.35) There was no significant difference between the two groups (P> 0.05). After treatment, the HAMD score of the test group was (14.25 ± 2.38), the HAMA score was (11.33 ± 2.56) and the control group was (17.24 ± 2.45) and the HAMA score was (15.19 ± 2.72) points (P <0.05). The total effective rate was 90.32% (28/31 cases) in the test group and 83.87% (26/31 cases) in the control group, with no significant difference (P> 0.05). There were 2 cases of drowsiness, 3 cases of dizziness and nausea, 1 case of upper extremity tremor in the control group, 3 cases of dizziness and 2 cases of nausea. The adverse drug reaction rate was 25.81% (8/31 cases) in the test group and 19.35% (6/31 cases) in the control group, with no significant difference (P> 0.05). Conclusion The efficacy and safety of estazolam and paroxetine hydrochloride in elderly patients with ulcerative colitis and depression are similar, but paroxetine hydrochloride improves anxiety and depression in patients with better effect.