【摘要】：目的:調(diào)查并比較不同年代某院住院抑郁癥患者的藥物使用情況,表明了醫(yī)生對抑郁癥治療的用藥變遷及現(xiàn)狀,為抑郁癥的臨床合理用藥提供參考。方法:采用回顧性研究方法,在某精神病�？漆t(yī)院病案室中查閱1995年、2005年、2015年抑郁癥患者的住院病歷,從中抽取符合入組標(biāo)準(zhǔn)的病歷共234份,其中1995年43份、2005年96份、2015年95份。使用自制調(diào)查表收集患者的一般情況、用藥情況等,采用SPSS19.0對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)處理。結(jié)果:234份病歷中,患者年齡在26~50歲之間,平均(38.96±6.429)歲,其中男性96例(41.0%),女性138例(59.0%);總病程在0.5~240個(gè)月之間,平均(25.34±43.132)個(gè)月,住院時(shí)間14~192天,平均(42.64±27.928)天。(1)1995年40例(93.0%)患者使用了三環(huán)類抗抑郁藥,3例(7.0%)患者未使用抗抑郁藥;2005年35例(36.5%)患者服用了三環(huán)類抗抑郁藥,80例(83.3%)患者服用了新型抗抑郁藥,常用藥物依次為帕羅西汀、氟西汀、文拉法辛、西酞普蘭;2015年,所有患者均使用新型抗抑郁藥,常用藥物依次為度洛西汀、曲唑酮、舍曲林、帕羅西汀,僅有1例(1.1%)患者使用了三環(huán)類抗抑郁藥。(2)1995年,34例(79.1%)患者使用一種抗抑郁藥,3例患者(7.0%)同時(shí)使用兩種抗抑郁藥;2005年66例(68.8%)患者使用一種抗抑郁藥,17例(17.7%)患者同時(shí)使用兩種抗抑郁藥;2015年42例(44.2%)患者使用一種抗抑郁藥,47例(49.5%)患者同時(shí)使用兩種抗抑郁藥,3例(3.2%)患者同時(shí)服用三種抗抑郁藥。(3)三個(gè)年代中分別有38例(88.4%)、91例(94.8%)和88例(92.6%)患者使用苯二氮卓類藥物,使用最多的是氯硝西泮和阿普唑侖。其中1995年中有24例(55.8%)患者使用一種苯二氮卓類藥物,10例(26.3%)患者同時(shí)服用兩種苯二氮卓類藥物,1例(2.6%)患者同時(shí)服用三種苯二氮卓類藥物;2005年40例(44.0%)患者服用一種苯二氮卓類藥物,9例(9.9%)患者同時(shí)服用兩種苯二氮卓類藥物;2015年35(39.8%)患者服用一種苯二氮卓類藥物,39(44.3%)患者同時(shí)服用兩種苯二氮卓類藥物,3例(3.4%)患者同時(shí)服用三種苯二氮卓類藥物(4)三個(gè)年代中,分別有22例(51.2%)、70例(72.9%)和58例(61.1%)患者服用了抗精神病藥,其中服用一種抗精神病藥分別為20例(90.9%)、40例(57.1%)、44例(75.9%);同時(shí)服用兩種以上抗精神病藥的有2例(9.1%)、26例(37.1%)和10例(17.2%)。(5)三個(gè)年代中合并心境穩(wěn)定劑的分別占2例(4.7%)、20例(20.8%)、10例(10.5%)。(6)三個(gè)年代中,使用精神藥物的總數(shù)量分別為(3.37±1.398)種、(4.52±1.451)種、(4.59±1.498)種。結(jié)論:1.隨著時(shí)代的變遷,新型抗抑郁藥治療抑郁癥已成為臨床用藥的主流,用藥趨于多樣化;2.抗抑郁藥之間的合并用藥增多;3.苯二氮卓類藥物在抑郁患者中的使用增多;4.典型抗精神病藥的使用減少,非典型抗精神病藥的使用增多,兩種以上抗精神病藥同時(shí)使用明顯增多;5.抑郁患者使用精神藥物的總數(shù)目增加。
[Abstract]:Objective: to investigate and compare the drug use of depressive patients in a hospital in different years, and to show the changes and current situation of the treatment of depression by doctors, and to provide a reference for the rational use of depression in clinic. Methods: a retrospective study was carried out in a medical records room of a psychiatric hospital. 234 medical records of depression patients were collected from the medical records of 1995, 2005 and 2015. 234 medical records were collected from the medical records, 43 in 1995 and 96 in 2005. 95 in 2015. Self-made questionnaire was used to collect the general situation and drug use of patients, and SPSS19.0 was used to deal with the data. Results: the mean age of the patients was (38.96 鹵6.429) years, 96 males (41.0%) and 138females (59.0%). The total course of disease ranged from 0.5 to 240 months, with an average of (25.34 鹵43.132) months, and the hospitalization time was 140.192 days, with an average of (42.64 鹵27.928) days. (1) in 1995, 40 patients (93.0%) were treated with tricyclic antidepressants. No antidepressants were used in 3 patients (7.0%). In 2005, 35 (36.5%) patients took tricyclic antidepressants and 80 (83.3%) patients took new antidepressants. The commonly used drugs were paroxetine, fluoxetine, venlafaxine and citalopram. In 2015, all patients were treated with new antidepressants, followed by doxicetine, trazodone, sertraline, paroxetine, and only one patient (1.1%) received tricyclic antidepressants. (2) in 1995, One antidepressant was used in 34 patients (79.1%) and two antidepressants in 3 patients (7.0%). One antidepressant was used in 66 patients (68.8%) and two antidepressants in 17 patients (17.7%) in 2005. In 2015, 42 patients (44.2%) were treated with one antidepressant and 47 (49.5%) with two antidepressants. Three patients (3.2%) took three antidepressants at the same time. (3) in the three decades, 38 (88.4%), 91 (94.8%) and 88 (92.6%) patients were treated with benzodiazepines, respectively. Clonazepam and alprazolam were used most frequently. In 1995, 24 patients (55.8%) received one benzodiazepines, 10 patients (26.3%) took two benzodiazepines, and one patient (2.6%) took three benzodiazepines at the same time. In 2005, 40 patients (44.0%) took one benzodiazepine and 9 patients (9.9%) took two benzodiazepines at the same time. In 2015, 35 (39.8%) patients took one benzodiazepine and 39 (44.3%) patients took two benzodiazepines at the same time. In 3 cases (3.4%), 22 cases (51.2%), 70 cases (72.9%) and 58 cases (61.1%) took antipsychotic drugs simultaneously. 20 cases (90.9%) were taken one antipsychotic drug, 40 cases (57.1%) and 44 cases (75.9%) respectively. Two patients (9.1%) took more than two antipsychotics at the same time, 26 cases (37.1%) and 10 cases (17.2%). (5) were treated with mood stabilizers in 2 cases (4.7%). In 20 cases (20.8%) and 10 cases (10.5%). (6), the total number of psychotropic drugs was (3.37 鹵1.398) species, (4.52 鹵1.451) species, (4.59 鹵1.498) species, respectively. Conclusion: 1. With the change of times, new antidepressants have become the mainstream of clinical treatment of depression, drug use tends to diversification; 2. The combined use of antidepressants increased; The use of benzodiazepines in patients with depression increased; 4. The use of typical antipsychotics decreased, the use of atypical antipsychotics increased, more than two kinds of antipsychotics at the same time increased significantly. The total number of patients with depression using psychotropic drugs increased.
【學(xué)位授予單位】：濟(jì)寧醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.4

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