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盐酸文拉法辛联合坦度螺酮治疗伴有躯体症状血管性抑郁的疗效及安全性：一项开放标签随机对照试验。

Efficacy and safety of venlafaxine hydrochloride combined with tandospirone citrate for patients with vascular depression accompanied by somatic symptoms: An open-labeled randomized control trial.

机构信息

Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China.

Department of Neurology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China.

出版信息

CNS Neurosci Ther. 2024 Mar;30(3):e14650. doi: 10.1111/cns.14650.

DOI:10.1111/cns.14650
PMID:38514905
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10957720/
Abstract

AIMS

To explore the pharmacological treatment of vascular depression (VaDep) and whether the blood levels of neurotransmitters can reflect the VaDep severity.

METHODS

VaDep patients with somatic symptoms were enrolled and randomly received venlafaxine + tandospirone (Combined Group) or venlafaxine (Monotherapy Group). The treatment efficacy was assessed by Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Patient Health Questionnaire-15 (PHQ-15). The levels of blood monoamine neurotransmitters were measured by enzyme-linked immunosorbent assay.

RESULTS

Both groups reported a progressive decrease in HAMD, HAMA, and PHQ-15 scores to below the baseline after the respective treatment. Compared with the Monotherapy Group, the Combined Group reported a significant decrease in HAMD score at week 2 and markedly lower HAMA and PHQ-15 scores at weeks 1, 2, 4, and 8. Both groups showed a decrease in the levels of blood monoamine neurotransmitters at weeks 4 and 8 when compared with the baseline. A strong positive association was evident between the plasma 5-HT levels and the HAMD score.

CONCLUSION

The combined therapy rapidly acts on VaDep comorbid with anxiety and somatic symptoms and significantly alleviates the anxiety and somatic symptoms. The plasma levels of 5-HT may serve as potential objective candidates in evaluating VaDep severity and the efficacy of the undertaken treatment regimen.

摘要

目的

探讨血管性抑郁（VaDep）的药物治疗方法，以及神经递质的血液水平是否能反映 VaDep 的严重程度。

方法

纳入伴有躯体症状的 VaDep 患者，并随机接受文拉法辛+坦度螺酮（联合组）或文拉法辛（单药组）治疗。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和患者健康问卷-15 （PHQ-15）评估治疗效果。采用酶联免疫吸附试验测定血液单胺神经递质水平。

结果

两组患者在各自治疗后 HAMD、HAMA 和 PHQ-15 评分均逐渐下降至低于基线。与单药组相比，联合组在第 2 周 HAMD 评分显著下降，第 1、2、4 和 8 周 HAMA 和 PHQ-15 评分明显降低。与基线相比，两组在第 4 周和第 8 周时血液单胺神经递质水平均下降。血浆 5-HT 水平与 HAMD 评分呈强正相关。

结论

联合治疗对伴焦虑和躯体症状的 VaDep 迅速起效，显著缓解焦虑和躯体症状。血浆 5-HT 水平可能成为评估 VaDep 严重程度和所采用治疗方案疗效的潜在客观候选指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/93fa5ca573e6/CNS-30-e14650-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/1601fb0d6e25/CNS-30-e14650-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/4ca16619d4fa/CNS-30-e14650-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/93fa5ca573e6/CNS-30-e14650-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/1601fb0d6e25/CNS-30-e14650-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/4ca16619d4fa/CNS-30-e14650-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc99/10957720/93fa5ca573e6/CNS-30-e14650-g003.jpg

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