文拉法辛联合认知行为疗法治疗帕金森病抑郁、认知功能障碍的临床疗效评价

目的:探讨文拉法辛联合认知行为疗法治疗帕金森病(PD)抑郁、认知功能障碍的临床疗效和安全性。方法:选择我院收治的60例PD合并抑郁、认知功能障碍患者并将其随机分为三组,分别为对照组(单用文拉法辛治疗),联合奥氮平组(文拉法辛联合奥氮平),联合认知行为疗法组(文拉法辛联合认知行为疗法),每组20例,于治疗前及治疗后4、8周末采用汉密尔顿抑郁量表(HAMD)进行抑郁程度评定,简易精神状态评价量表(MMSE)和事件相关电位(event-related potentials,ERPs)P300进行认知功能评定。结果:治疗4、8周时,三组的HAMD评分均较治疗前有不同程度下降,P300潜伏期较治疗前有不同程度缩短,P300波幅、MMSE评分有不同程度升高(P0.05),联合奥氮平组和联合认知行为疗法组HAMD评分较对照组明显下降,P300潜伏期较对照组明显缩短,P300波幅、MMSE评分明显升高(P0.05),联合认知行为疗法组HAMD评分较联合奥氮平组明显下降,P300潜伏期明显缩短,P300波幅、MMSE评分明显升高(P0.05)。三组均无特殊不良反应。结论:文拉法辛联合认知行为疗法治疗PD抑郁、认知功能障碍疗效确切,能显著改善患者抑郁症状,提高患者的认知功能,疗效较单用文拉法辛或文拉法辛联合奥氮平治疗更好,且安全性高。

Evaluation of the Clinical Effect of Venlafaxine Combined with Cognitive Behavioral Therapy on the Parkinson's Disease with Depression and Cognitive Dysfunction

ABSTRACT Objective: To investigate the clinical efficacy and safety of venlafaxine combined with cognitive behavior therapy in the treatment of Parkinson''s disease (PD) combined with depression and cognitive dysfunction. Methods: Sixty Parkinson''s patients with depression and cognitive dysfunction in our hospital were randomly divided into three groups: the control group (treated with venlafaxine alone), venlafaxine combined with olanzapine, venlafaxine combined with cognitive behavior therapy group, 20 cases in each group. The degree of depression was assessed by Hamilton Depression Scale(HAMD) before and at 4 and 8 weeks after the treatment, The degree of cognitive dysfunction was assessed by Mini-Mental State Examination (MMSE)and event-related potentials P300 before and at 4 and 8 weeks after the treatment. Results: At 4 and 8 weeks after treatment, the HAMD scores of three groups were decreased to different de- grees than those before treatment, P300 latency was shorter than those before treatment, P300 amplitude and MMSE scores were in- creased to different degrees (P<0.05). The HAMD scores of combined olanzapine group and combined cognitive behavior therapy group were significantly lower than that of the control group. The latency of P300 were significantly shorter than that of the control group, and the P300 amplitude and MMSE score were significantly increased (P<0.05). The HAMD score of combined cognitive behavior group was significantly lower than that of the olanzapine group, the P300 latency was shortened, the P300 amplitude and MMSE score were significantly increased (P<0.05). There was no special adverse reactions in the three groups. Conclusion: Venlafaxine combined with cognitive behavior therapy was effective in the treatment of PD relted depression and cognitive dysfunction, it could significantly im- prove the symptoms of depression, cognitive function and was superior to venlafaxine or venlafaxine combined with olanzapine treatment with high safety.