不同剂量艾司西酞普兰治疗广泛性焦虑患者的疗效及对5-HT、GABA含量的影响

doi:10.3969/j.issn.1671-7171.2023.09.007

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摘要【目的】探讨不同剂量艾司西酞普兰治疗广泛性焦虑(GAD)患者的疗效及对血浆5-羟色胺(5-HT)、γ-氨基丁酸(GABA)含量的影响。【方法】本院收治的86例GAD患者,依据治疗药物艾司西酞普兰剂量不同分为低剂量组、中剂量组和高剂量组,低剂量组初始剂量为5 mg/d,中剂量组为10 mg/d,高剂量组为20 mg/d。比较三组的疗效、汉密尔顿焦虑量表(HAMA)评分、临床疗效总体评定量表(CGI-SI)评分、血浆5-HT和GABA的含量及不良反应发生率。【结果】中剂量组和高剂量组总有效率分别为93.10%(27/29)、96.30%(26/27),明显高于低剂量组的73.33%(22/30)(均P<0.05);中剂量组与高剂量组总有效率比较,差异无统计学意义(P>0.05)。三组患者治疗后HAMA、CGI-SI评分均低于同组治疗前(P<0.05);中剂量组和高剂量组治疗后HAMA评分均显著低于低剂量组(P<0.05),但中剂量组和高剂量组比较,差异无统计学意义(P>0.05)。三组患者治疗后血浆5-HT、GABA的含量均高于同组治疗前(P<0.05);中剂量组和高剂量组治疗后血浆5-HT、GABA的含量显著高于低剂量组(P<0.05);但中剂量组和高剂量组比较,差异无统计学意义(P>0.05)。低剂量组和中剂量组不良发应发生率分别为10.00%(3/30)、17.24%(3/29),显著低于高剂量组的44.44%(12/27)(P<0.05);低剂量组和中剂量组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】相较于低剂量艾司西酞普兰治疗GAD患者,中、高剂量能够获得更好疗效,有效缓解患者临床症状,且中剂量组不良反应发生率低于高剂量组,安全性较高。

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	曹静
	李娟

关键词 ：焦虑/药物疗法, 抗焦虑药, 血清素, γ氨基丁酸, 治疗结果

Abstract：【Objective】To explore the efficacy of different dosages of escitalopram in the treatment of patients with generalized anxiety disorder (GAD) and its effect on plasma levels of 5-hydroxytryptamine (5-HT) and γ-aminobutyric acid (GABA).【Methods】A total of 86 patients with GAD admitted to our hospital were divided into the low,medium,and high dosage groups according to the different dosages of the treatment drug escitalopram,with initial dosages of 5 mg/d (low),10 mg/d (medium),and 20 mg/ d (high),respectively. The efficacy,Hamilton Anxiety Scale (HAMA) scores,Clinical Global Impression-Severity Scale (CGI-SI) scores,plasma levels of 5-HT and GABA,and the incidence of adverse reactions were compared among the three groups.【Results】The total effective rates in the medium-dosage group and high-dosage group were 93.10% (27/29) and 96.30% (26/27),respectively,which were significantly higher than 73.33% (22/30) in the low-dosage group (all P<0.05). There was no statistically significant difference in the total effective rate between the medium-dosage group and high-dosage group (P>0.05). HAMA and CGI-SI scores of the three groups after treatment were lower than those before treatment (P<0.05). The HAMA scores of the medium-dosage group and high-dosage group were significantly lower than that of the low-dosage group after treatment (P<0.05),but there was no statistically significant difference between the medium-dosage group and high-dosage group (P>0.05). The plasma levels of 5-HT and GABA in the three groups after treatment were higher than those before treatment (P<0.05). The plasma levels of 5-HT and GABA in the medium-dosage group and high-dosage group were significantly higher than those in the low-dosage group after treatment (P<0.05),but there was no statistically significant difference between the medium-dosage group and high-dosage group (P>0.05). The incidence of adverse reactions in the low-dosage group and medium-dosage group was 10.00% (3/30) and 17.24% (3/29),which were significantly lower than the 44.44% (12/27) in the high-dosage group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the low-dosage group and medium-dosage group (P>0.05).【Conclusion】Compared with low-dosage escitalopram treatment for patients with GAD,medium and high dosages can achieve better efficacy through effectively alleviating patients' clinical symptoms. And the medium-dosage group has a lower incidence of adverse reactions than the high-dosage group,with higher safety.

Key words： Anxiety/DT Anti-Anxiety Agents Serotonin Gamma-Aminobutyric Acid Treatment Outcome

收稿日期: 2022-10-15

中图分类号:

R749.72

通讯作者: *E-mail:1256442556@qq.com

引用本文:

曹静, 李娟. 不同剂量艾司西酞普兰治疗广泛性焦虑患者的疗效及对5-HT、GABA含量的影响[J]. 医学临床研究, 2023, 40(9): 1303-1306.
CAO Jing, LI Juan. Efficacy of Different Dosages of Escitalopram in the Treatment of Generalized Anxiety Disorder Patients and its Impact on 5-HT and GABA Levels. JOURNAL OF CLINICAL RESEARCH, 2023, 40(9): 1303-1306.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.09.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I9/1303

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