目的 探討喹硫平聯(lián)合伏硫西汀治療難治性抑郁癥的臨床療效。方法 選取2018年11月-2019年10月在天津市安定醫(yī)院治療的難治性抑郁癥患者159例，隨機(jī)分為對(duì)照組（81例）和治療組（78例）。對(duì)照組口服氫溴酸伏硫西汀片，初始劑量為10 mg/d，1~2周后加至20 mg/d。治療組在對(duì)照組的基礎(chǔ)上口服富馬酸喹硫平片，初始劑量為0.1 g/d，1~2周后增加到0.2 g/d。兩組患者均連續(xù)治療8周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者漢密爾頓抑郁量表（HAMD）評(píng)分、重復(fù)成套神經(jīng)心理狀態(tài)測(cè)驗(yàn)（RBANS）評(píng)分，及血清白細(xì)胞介素-6（IL-6）、IL-8、腫瘤壞死因子-α（TNF-α）和干擾素-γ（IFN-γ）水平。結(jié)果 治療后，對(duì)照組臨床有效率為72.84%，顯著低于治療組的85.90%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組HAMD在第2、4、8周末均明顯下降（P<0.05），且治療組在第4、8周末評(píng)分降低更明顯（P<0.05）。治療后，兩組RBANS評(píng)分在第4、8周末均顯著升高（P<0.05），且治療組在第4、8周末均顯著高于對(duì)照組（P<0.05）。治療后，兩組患者IL-6、IL-8、TNF-α、IFN-γ水平顯著降低（P<0.05），且治療組水平顯著低于對(duì)照組（P<0.05）。結(jié)論 伏硫西汀聯(lián)合喹硫平治療難治性抑郁癥起效快，可提高患者認(rèn)知功能，安全性高。

Objective To investigate the clinical efficacy of quetiapine combined with vortioxetine in treatment of refractory depression. Methods Patients (159 cases) with refractory depression in Tianjin Anding Hospital from November 2018 to October 2019 were randomly divided into control (81 cases) and treatment (78 cases) groups. Patients in the control group were po administered with Vortioxetine Hydrobromide Tablets, the initial dose was 10 mg/d, and then increased to 20 mg/d after 1-2 weeks. Patients in the treatment group were po administered with Quetiapine Fumarate Tablets on the basis of the control group, the initial dose was 0.1 g/d, and then increased to 0.2 g/d after 1-2 weeks. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the HAMD scores, RBANS scores, and the serum level of IL-6, IL-8, TNF-α and IFN-γ in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 72.84%, which was significantly lower than 85.90% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the HAMD scores in two groups were significantly decreased (P < 0.05) at the end of the 2nd, 4th and 8th week, and which in the treatment group were significantly lower than that in the control group at the end of the 4th and 8th week (P < 0.05). After treatment, the RBANS scores in two groups were significantly increased (P < 0.05) at the end of the 4th and 8th week, and which in the treatment group were significantly higher than that in the control group at the end of the 4th and 8th week (P < 0.05). After treatment, the serum levels of IL-6, IL-8, TNF-α and IFN-γ in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Quetiapine combined with vortioxetine in treatment of refractory depression has a fast onset, can improve the cognitive function and has high safety.

R971

蘇州市科技局指導(dǎo)性項(xiàng)目（SYSD2018165）