本文選題：度洛西汀 + 心腦寧膠囊�。� 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的:觀察度洛西汀及心腦寧膠囊聯(lián)合用藥對(duì)晚發(fā)性抑郁患者認(rèn)知功能的作用和臨床療效。方法:根據(jù)入組排除標(biāo)準(zhǔn)選2015年8月-2016年12月蘭州大學(xué)第二醫(yī)院門診或住院晚發(fā)性抑郁癥患者70例(病例組),限制性隨機(jī)分組分聯(lián)合組(度洛西汀聯(lián)合心腦寧膠囊)和西藥組(度洛西汀),治療前與治療第2、4、8、12周末采用漢密爾頓抑郁量表(HAMD-24)評(píng)定抑郁程度及藥物副反應(yīng)量表評(píng)定不良反應(yīng);治療前與治療第12周末進(jìn)行認(rèn)知功能測(cè)評(píng)(數(shù)字廣度、無(wú)意義圖形再認(rèn)、連線測(cè)試、數(shù)字符號(hào)、威斯康星卡片分類測(cè)驗(yàn)、字色干擾試驗(yàn)、詞匯流暢性測(cè)驗(yàn))和日常生活能力量表測(cè)評(píng)。根據(jù)入組標(biāo)準(zhǔn)選50例健康老年人(正常對(duì)照組)進(jìn)行認(rèn)知功能和日常生活能力測(cè)評(píng)。比較治療前病例組與正常對(duì)照組認(rèn)知功能和日常生活能力;比較聯(lián)合組與西藥組療效、對(duì)認(rèn)知功能的作用和不良反應(yīng);比較治療后聯(lián)合組與正常對(duì)照組認(rèn)知功能和日常生活能力。結(jié)果:1.治療前病例組在數(shù)字廣度-順背、無(wú)意義圖形再認(rèn)、數(shù)字符號(hào)、數(shù)字廣度-倒背、WCST完成分類數(shù)、stroop-c、stroop-cw、詞匯流暢性測(cè)驗(yàn)等認(rèn)知功能相關(guān)測(cè)試評(píng)分均低于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);WCST隨機(jī)錯(cuò)誤數(shù)、WCST持續(xù)錯(cuò)誤數(shù)、連線測(cè)試A、連線測(cè)試B、ADL評(píng)分均高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。2.HAMD24評(píng)分重復(fù)測(cè)量方差分析結(jié)果顯示:組間和組內(nèi)差異均有統(tǒng)計(jì)學(xué)意義(P0.05或P0.01);時(shí)間與分組無(wú)交互作用(P0.05)。組間各時(shí)間點(diǎn)比較,治療第2、4周末聯(lián)合組與西藥組HAMD24評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),治療第8、12周末聯(lián)合組HAMD24評(píng)分低于西藥組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合組有效率高于西藥組(91.43%vs.71.43%),差異有統(tǒng)計(jì)學(xué)意義(P0.05),痊愈率(28.57%vs.20.00%)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療第12周末,組內(nèi)比較,聯(lián)合組數(shù)字廣度-順背、無(wú)意義圖形再認(rèn)、數(shù)字符號(hào)、數(shù)字廣度-倒背、WCST完成分類數(shù)、stroop-c、stroop-cw、詞匯流暢性測(cè)驗(yàn)評(píng)分均高于治療前,WCST隨機(jī)錯(cuò)誤數(shù)、WCST持續(xù)錯(cuò)誤數(shù)、連線測(cè)試A、連線測(cè)試B、ADL評(píng)分均低于治療前,差異顯著(P0.01);西藥組數(shù)字廣度-順背、無(wú)意義圖形再認(rèn)、數(shù)字符號(hào)、數(shù)字廣度-倒背評(píng)分均高于治療前,連線測(cè)試A、連線測(cè)試B、ADL評(píng)分低于治療前,差異顯著(P0.01),WCST完成分類數(shù)、WCST隨機(jī)錯(cuò)誤數(shù)、WCST持續(xù)錯(cuò)誤數(shù)、stroop-c、stroop-cw、詞匯流暢性測(cè)驗(yàn)評(píng)分與治療前相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療第12周末,組間比較,聯(lián)合組數(shù)字符號(hào)、數(shù)字廣度-倒背、WCST完成分類數(shù)、stroop-c、stroop-cw、詞匯流暢性測(cè)驗(yàn)評(píng)分均高于西藥組,WCST隨機(jī)錯(cuò)誤數(shù)、WCST持續(xù)錯(cuò)誤數(shù)、連線測(cè)試B、ADL評(píng)分低于西藥組,差異有統(tǒng)計(jì)學(xué)意義(P0.05或P0.01),數(shù)字廣度-順背、無(wú)意義圖形再認(rèn)、連線測(cè)試A與西藥組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.治療第12周末,聯(lián)合組數(shù)字廣度-順背、無(wú)意義圖形再認(rèn)、數(shù)字廣度-倒背、WCST完成分類數(shù)、stroop-c、stroop-cw、詞匯流暢性測(cè)驗(yàn)評(píng)分均低于正常對(duì)照組,連線測(cè)試A、WCST隨機(jī)錯(cuò)誤數(shù)、WCST持續(xù)錯(cuò)誤數(shù)、連線測(cè)試B、ADL評(píng)分均高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01或P0.05);聯(lián)合組數(shù)字符號(hào)評(píng)分與正常對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5.聯(lián)合組與西藥組不良反應(yīng)事件發(fā)生頻率差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.467,P0.05)。結(jié)論:1.晚發(fā)性抑郁患者存在短時(shí)記憶、注意、執(zhí)行功能等認(rèn)知功能障礙。2.度洛西汀聯(lián)合心腦寧膠囊與單用度洛西汀治療晚發(fā)性抑郁均有效,安全性均好。3.聯(lián)合心腦寧膠囊比單用度洛西汀治療LOD的抗抑郁療效更顯著,對(duì)持續(xù)性注意、注意的轉(zhuǎn)換功能和執(zhí)行功能方面認(rèn)知損害的改善作用更明顯。
[Abstract]:Objective: To observe the effect and clinical effect of duloxetine and Xin nnning Capsule on the cognitive function of patients with late onset depression. Methods: according to the exclusion criteria, 70 cases of late onset depression in Second Hospital Affiliated to Lanzhou University in August 2015, December, -2016 (case group), restricted randomized grouping combined group (duloxi) Tine and Xin nnning capsule) and Western medicine group (duloxetine), before and after treatment for 2,4,8,12 weekend, the Hamilton Depression Scale (HAMD-24) was used to assess the depressive degree and drug side reaction scale to assess the adverse reaction. The cognitive function assessment (Digital breadth, meaningless graphic recognition, connection test, digital character) before and twelfth weekend treatment was evaluated. Number, Wisconsin card classification test, word color interference test, vocabulary fluency test, and daily living capacity scale assessment. The cognitive function and daily living ability of 50 healthy elderly people (normal control group) were selected according to the standard of entry group. The cognitive function and daily living ability of the pre treatment and normal control group were compared. The effect of combination group and Western Medicine Group on cognitive function and adverse reaction; compare the cognitive function and daily life ability of the combined group and the normal control group after treatment. Results: 1. before treatment, the case group was in the digital breadth - CIS back, no meaningful graphic recognition, digital symbols, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, fluency of vocabulary. The score of cognitive function test, such as sex test, was lower than that of the normal control group, and the difference was statistically significant (P0.01); the WCST random error number, the WCST continuous error number, the connection test A, the connection test B, and the ADL score were all higher than those of the normal control group, the difference was statistically significant (P0.01) and the results of the repeated measurement of variance analysis of.2.HAMD24 score showed: in group and in group The difference was statistically significant (P0.05 or P0.01); there was no interaction between time and group (P0.05). There was no significant difference in the HAMD24 score between the combination group and the western medicine group at the end of the group 2,4 weekend (P0.05). The HAMD24 score of the combined group was lower than that in the western medicine group (P0.05). The effective rate of the combined group was high. In the western medicine group (91.43%vs.71.43%), the difference was statistically significant (P0.05), and the difference in recovery rate (28.57%vs.20.00%) was not statistically significant (P0.05) for the twelfth weekend of.3. treatment. In the group, the combined group digital breadth - CIS back, no meaningful graphic recognition, digital symbols, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, vocabulary fluency test The scores were all higher than before the treatment, WCST random error number, WCST continuous error number, line test A, line test B, ADL score were lower than before treatment, the difference was significant (P0.01); the western medicine group digital breadth - CIS back, no meaningful graphic recognition, digital symbol, digital breadth - back score were higher than before treatment, connection test A, connection test B, ADL score below treatment Before, the difference was significant (P0.01), the number of WCST completed, the number of WCST random errors, the number of WCST continuous errors, stroop-c, stroop-cw, and the vocabulary fluency test score was not statistically significant (P0.05). The twelfth weekend, the group comparison, the combined group digital symbols, the digital breadth back, the WCST complete classification, stroop-c, stroop-cw, and the vocabulary. The fluency test scores were higher than the western medicine group, the WCST random error number, the WCST continuous error number, the connection test B, and the ADL score lower than the western medicine group, the difference was statistically significant (P0.05 or P0.01), the digital breadth - CIS back, the non sense graphic recognition, the connection test A and the western medicine group, the difference was not statistically significant (P0.05).4. treatment twelfth weekend, the combined group number Word breadth - CIS back, nonsense graphic recognition, digital breadth - back, WCST complete classification, stroop-c, stroop-cw, the vocabulary fluency test scores were lower than the normal control group, the line test A, the WCST random error number, the WCST continuous error number, the connection test B, the ADL score higher than the normal control group, the difference was statistically significant (P0.01 or P0.05); the difference was statistically significant (P0.01 or P0.05); the difference was statistically significant (P0.01 or P0.05); the statistical significance was statistically significant (P0.01 or P0.05); the statistical significance was statistically significant There was no significant difference between the score of group digital symbols and the normal control group (P0.05) there was no significant difference in the frequency of adverse events between the.5. combined group and the western medicine group (x 2=0.467, P0.05). Conclusion: 1. the patients with late onset depression have short time memory, attention, executive function and other cognitive dysfunction.2. degrees luoxetine combined heart NanNin capsule and single The use of luoxetine is effective in the treatment of late onset depression. The safety of.3. combined with cardio NanNin capsule is more significant than that of single use luoxetine in the treatment of LOD. It is more significant for the improvement of cognitive impairment in continuous attention, attention to conversion and executive function.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749.4

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