本文關鍵詞： 癲癇 5-HT1A受體激動劑 坦度螺酮 抑郁 焦慮　出處：《山西醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：通過對漢密爾頓抑郁量表(HAM-D)及漢密爾頓焦慮量表(HAM-A)的測評,觀察5-TH1A受體激動劑枸櫞酸坦度螺酮對癲癇合并抑郁與焦慮患者治療的療效,為癲癇后抑郁與焦慮的臨床診斷和治療提供新思路。 方法：收集山西醫(yī)科大學第一臨床醫(yī)院及山西醫(yī)科大學第三醫(yī)院神經內科2012.11—2013.11門診及住院的癲癇合并焦慮抑郁患者134例,分為治療組91例和對照組43例。治療組在常規(guī)口服抗癲癇藥物及心理疏導的基礎上加服坦度螺酮,每次lOmg,每日三次；對照組服用常規(guī)抗癲癇藥物接受心理疏導,療程8周。兩組分別在使用5-羥色胺1A受體激動劑枸櫞酸坦度螺酮治療前和治療后2周、4周、8周進行漢密爾頓抑郁量表(HAM-D)及漢密爾頓焦慮量表(HAM-A)評分變化,評定抑郁、焦慮情況。同時記錄每組病人服藥期間癲癇發(fā)作次數(shù)的改變。統(tǒng)計采用SPSS17.0統(tǒng)計軟件包進行統(tǒng)計。HAMA及HAMD評分以均數(shù)±標準差(x+s)表示,比較采用配對t檢驗,P0.05差異有統(tǒng)計學意義。根據數(shù)據特征,癲癇發(fā)作次數(shù)用中位數(shù)(四分位間距)[M(P25,p75)]表示,兩組間比較采用Mann-Whitney U檢驗,P0.05差異有統(tǒng)計學意義。癲癇療效及焦慮抑郁療效兩組間比較采用卡方(X2)檢驗,P0.05差異有統(tǒng)計學意義。 結果：1.治療2周末,治療組與對照組比較無明顯差異(P0.05)；4周末開始,治療組與對照組比較,治療后HAMD評分與HAMA評分均顯著性減低。治療4周后,治療組前后比較,HAMD評分與HAMA評分(P0.05)均明顯下降；2.與對照組比較,治療組隨訪8周后發(fā)作次數(shù)明顯減少,有統(tǒng)計學意義(U=-2.92,P0.05)。3.兩組未見嚴重不良反應,枸櫞酸坦度螺酮具有很好的安全性。 結論：通過治療組及對照組患者治療前及治療后2、4、8周對漢密爾頓抑郁量表(HAM-D)及漢密爾頓焦慮量表(HAM-A)測評結果顯示：1)5-TH1A受體激動劑枸櫞酸坦度螺酮對伴有焦慮與抑郁狀態(tài)的癲癇患者可以全面改善焦慮抑郁障礙的所有癥狀,有助于糾正患者的負面情緒,提高治愈率；2)5-TH1A受體激動劑枸櫞酸坦度螺酮可對于合并焦慮與抑郁狀態(tài)的癲癇患者可以減少癲癇的發(fā)作,是良好的藥物。3)隨著用藥時間的延長抗焦慮,抗抑郁的療效越好。
[Abstract]:Objective: to evaluate the Hamilton Depression scale (Hamilton Depression scale) and Hamilton anxiety scale (Hamilton anxiety scale). To observe the efficacy of 5-TH1A receptor agonist tandosterone citrate in the treatment of epileptic patients with depression and anxiety, and to provide a new idea for the clinical diagnosis and treatment of post-epileptic depression and anxiety. Methods: 134 patients with epilepsy complicated with anxiety and depression were collected from the first Clinical Hospital of Shanxi Medical University and the Department of Neurology of the third Hospital of Shanxi Medical University from November to March 2012.11. The treatment group was divided into treatment group (n = 91) and control group (n = 43). The control group was treated with conventional antiepileptic drugs for 8 weeks. The two groups were treated with 5-hydroxytryptamine 1A receptor agonist tandoproxone citrate for 4 weeks before and 2 weeks after treatment. After 8 weeks, the scores of Hamilton Depression scale (Hamd) and Hamilton anxiety scale (Hamilton anxiety scale) were changed to assess depression. Anxiety. At the same time, the changes of epileptic seizures in each group were recorded. The mean 鹵standard deviation of Hama and HAMD scores were calculated by SPSS17.0 statistical software package (P < 0.05). S). There was significant difference in pairing t test (P0.05). According to the characteristics of the data, the number of epileptic seizures was median (quartile spacing). [Mann-Whitney U test was used to compare the two groups. There was significant difference between the two groups in the therapeutic effect of epilepsy and anxiety and depression by chi-square X _ 2) test (P0.05). Results 1. At the end of 2 weeks, there was no significant difference between the treatment group and the control group (P 0.05). From the end of the 4th week, the HAMD score and HAMA score of the treatment group were significantly lower than those of the control group, and after 4 weeks of treatment, the comparison was made between the treatment group and the control group. HAMD score and HAMA score decreased significantly (P 0.05). 2.Compared with the control group, the number of seizures in the treatment group decreased significantly after 8 weeks follow-up, and there was no serious adverse reaction in the two groups. Tandoxone citrate has good safety. Conclusion: the patients in the treatment group and the control group were treated before and after treatment. In 8 weeks, the Hamilton Depression scale (Hamm) and the Hamilton anxiety scale (Hamilton anxiety scale) showed that: 1). The 5-TH1A receptor agonist tandolone citrate can improve all symptoms of anxiety and depression in epileptic patients with anxiety and depression. It is helpful to correct the negative emotion of the patients and improve the cure rate. 2Tanduspirone citrate, the agonist of 5-TH1A receptor, can reduce seizures in epileptic patients complicated with anxiety and depression. It is a good drug. 3) with the prolongation of medication time, anti-anxiety. The better the antidepressant effect.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R742.1

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