李博文　李劍蘭

【摘要】 目的：探討帕羅西汀聯(lián)合小劑量奧氮平治療抑郁癥并發(fā)睡眠障礙的臨床效果和藥品不良反應(yīng)。方法：選取2015年10月-2017年4月在本院就診抑郁癥并發(fā)睡眠障礙106例患者，隨機(jī)分成觀察組和對(duì)照組，每組各53例。對(duì)照組口服帕羅西汀治療，觀察組在對(duì)照組治療基礎(chǔ)上加服奧氮平治療。比較兩組入院時(shí)和入院4、12、24周后的漢密爾頓抑郁量表（HAMD）評(píng)分，觀察并比較兩組入院時(shí)和入院24周后匹茨堡睡眠質(zhì)量指數(shù)量表（PSQI）評(píng)分和不良反應(yīng)情況。結(jié)果：觀察組入院4、12、24周后的HAMD評(píng)分均明顯低于對(duì)照組（P<0.05）。入院24周后，觀察組PSQI各維度得分及PSQI總分均低于對(duì)照組（P<0.05）;且觀察組不良反應(yīng)發(fā)生率明顯低于對(duì)照組（P<0.05）。結(jié)論：帕羅西汀聯(lián)合小劑量奧氮平治療抑郁癥并發(fā)睡眠障礙起效快、療效確切，且不良反應(yīng)少。不僅有效改善抑郁癥患者的睡眠質(zhì)量，還協(xié)同增強(qiáng)抗抑郁、抗焦慮癥狀，提高患者的生活質(zhì)量。

【關(guān)鍵詞】 帕羅西汀; 奧氮平; 抑郁癥; 睡眠障礙

The Clinical Effects of Paroxetine Combined with Low Dose Olanzapine in the Treatment of Depression with Sleep Disorders/LI Bowen，LI Jianlan.//Medical Innovation of China，2019，16（19）：-145

【Abstract】 Objective：To explore the clinical effects and adverse drug reactions of Paroxetine combined with low dose Olanzapine in the treatment of depression with sleep disorders.Method：106 depression patients with sleep disorder from October 2015 to April 2017 in our hospital were selected and randomly divided into observation group and control group，53 cases in each groups.The control group were treated with Paroxetine orally，while the observation group were treated with Olanzapine on the basis of the control group.The Hamilton depression scale（HAMD）scores at admission and at 4，12，24 weeks after admission of two groups were compared.The pittsburgh sleep quality index（PSQI）scores at admission and 24 weeks after admission and the adverse reactions of two groups were observed and compared.Result：The HAMD scores at the 4，12，24 weeks after admission of the observation group were significantly lower than those of the control group（P<0.05）.The PSQI each dimension scores and the total scores after 24 weeks of admission of the observation group were lower than those in the control group（P<0.05）.And the incidence of adverse reactions of the observation group were significantly lower than that of the control group（P<0.05）.Conclusion：The Paroxetine combined with low dose Olanzapine in the treatment of depression with sleep disorders have fast onset，definite effects and less adverse reactions.It is not only effectively improves the sleep quality of patients with depression，but also synergistically enhances the symptoms of antidepressant and antianxiety，so as to improves the quality of life of patients.

【Key words】 Paroxetine; Olanzapine; Depression; Sleep disorders

First-authors address：Zhaoqing Veterans Hospital，Zhaoqing 526070，China

doi：10.3969/j.issn.1674-4985.2019.19.037