Lai Ai-luan, Zhao You-wen, Qi Hai-yan, Zhang Jian-sheng, Zhang Li-song, Weng Ya-qin
Department of Obstetrics and Gynecology, Affiliated Fuxing Hospital, Capital University of Medical Science, Beijing 100038, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Mar;42(3):169-72.
To study the effects of antidepression drugs and hormone replacement therapy (HRT) in perimenopausal and postmenopausal women with depression.
Eighty six perimenopausal and postmenopausal women with depression were divided into two groups, and treated for 12 weeks, respectively. Forty three received antidepression drugs as control group. Among them, mild to moderate depression were treated with deanxid (1 - 2 pills/d), and severe depression with fluoxetine (20 mg/d). Another 43 took Tibolone (livial) as HRT group (1.25 mg/d). All patients were assessed with the Hamilton depression rating scale for depression (HRSD) and self rating depression scale (SDS) before and at weeks 4, 8, 12 after treatment.
(1) Total effective rate of control and HRT groups was 96% and 93%, respectively, in mild-moderate depression (chi(2)=0.012, P>0.05), while there was a significant difference between two groups in severe depression. The overall effective rates were 93% (control group) and 42% (HRT group), respectively (chi(2) = 5.72, P < 0.01). (2) HRSD of mild-moderate depression was 26.8 +/- 5.7, 10.7 +/- 3.6, 6.4 +/- 3.6, 3.5 +/- 2.5, respectively in control group, and were 25.3 +/- 4.7, 15.2 +/- 5.3, 11.4 +/- 4.4, 4.4 +/- 3.8 in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference between two groups at weeks 0, and 12 after treatment (P>0.05). HRSD scores of severe depression were 37.6 +/- 5.6, 21.4 +/- 5.2, 14.2 +/- 4.2, 7.3 +/- 2.3, respectively, in control group, and were 38.2 +/- 4.8, 32.6 +/- 5.4, 28.2 +/- 4.6, 24.3 +/- 4.5, respectively, in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference in HRSD before treatment (P>0.05), but a significant difference at weeks 4, 8, and 12 between two groups (P<0.01). (3) SDS of mild and moderate as well as severe depression was significantly different at weeks 0, 4.8, and 12 in control group (P<0.01), while there was a difference in SDS of severe depression before treatment and at weeks 12 in HRT group (P<0.05). A significant reduction in HRSD and SDS of severe depression was demonstrated in control group than in HRT group (P<0.01)
Antidepression drugs and HRT can improve symptoms of depression in perimenopausal and postmenopausal women, but the effect of antidepression drugs is much better than HRT, especially in severe depression.
研究抗抑郁药物和激素替代疗法（HRT）对围绝经期及绝经后抑郁症女性的影响。
86例围绝经期及绝经后抑郁症女性被分为两组，分别接受为期12周的治疗。43例接受抗抑郁药物治疗作为对照组。其中，轻度至中度抑郁症患者服用黛安神（1 - 2片/天），重度抑郁症患者服用氟西汀（20毫克/天）。另外43例服用替勃龙（利维爱）作为HRT组（1.25毫克/天）。所有患者在治疗前及治疗后第4、8、12周用汉密尔顿抑郁量表（HRSD）和自评抑郁量表（SDS）进行评估。
（1）在轻度至中度抑郁症中，对照组和HRT组的总有效率分别为96%和93%（χ² = 0.012，P > 0.05），而在重度抑郁症中两组有显著差异。总体有效率分别为93%（对照组）和42%（HRT组）（χ² = 5.72，P < 0.01）。（2）对照组轻度至中度抑郁症患者治疗前及治疗后第4、8、12周的HRSD分别为26.8 ± 5.7、10.7 ± 3.6、6.4 ± 3.6、3.5 ± 2.5，HRT组分别为25.3 ± 4.7、15.2 ± 5.3、11.4 ± 4.4、4.4 ± 3.8。治疗前及治疗后第12周两组无差异（P > 0.05）。对照组重度抑郁症患者治疗前及治疗后第4、8、12周的HRSD分别为37.6 ± 5.6、21.4 ± 5.2、14.2 ± 4.2、7.3 ± 2.3，HRT组分别为38.2 ± 4.8、32.6 ± 5.4、28.2 ± 4.6、24.3 ± 4.5。治疗前HRSD无差异（P > 0.05），但治疗后第4、8、12周两组有显著差异（P < 0.01）。（3）对照组轻度、中度及重度抑郁症患者治疗前及治疗后第0、4、8、12周的SDS有显著差异（P < 0.01），而HRT组重度抑郁症患者治疗前及治疗后第12周的SDS有差异（P < 0.05）。重度抑郁症患者对照组的HRSD和SDS较HRT组有显著降低（P < 0.01）。
抗抑郁药物和HRT均可改善围绝经期及绝经后抑郁症女性的抑郁症状，但抗抑郁药物的效果远优于HRT，尤其是在重度抑郁症中。
