目的 探討鹽酸阿米替林片聯(lián)合鹽酸氟西汀分散片治療抑郁癥的臨床療效。方法 選取2016年1月-2017年6月重慶市精神衛(wèi)生中心收治的抑郁癥患者100例為研究對象，將所有患者依照隨機信封法分為對照組和治療組，每組各50例。對照組口服鹽酸氟西汀分散片，初始劑量20 mg/次，1次/d，依照病情變化情況適當增加劑量，最大劑量60 mg/d。治療組在對照組治療的基礎(chǔ)上口服鹽酸阿米替林片，75 mg/d，2次/d。兩組患者均連續(xù)治療3個月。觀察兩組的臨床療效，比較兩組的甲狀腺功能和漢密頓抑郁量表（HAMD）評分。結(jié)果 治療后，對照組和治療組的總有效率分別為84.00%、98.00%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組三碘甲狀原氨酸素（T3）、甲狀腺素（T4）水平均顯著降低，促甲狀腺素（TSH）水平顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組甲狀腺功能指標水平明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組HAMD評分均顯著降低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組HAMD評分明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 鹽酸阿米替林片聯(lián)合鹽酸氟西汀分散片治療抑郁癥具有較好的臨床療效，可降低HAMD評分，改善甲狀腺功能，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Amitriptyline Hydrochloride Tablets combined with Fluoxetine Hydrochloride Dispersible Tablets in treatment of depression. Methods Patients (100 cases) with depression in Chongqing Mental Health Center from January 2016 to June 2017 were randomly divided into control and treatment groups according to the random envelope method, and each group had 50 cases. Patients in the control group were po administered with Fluoxetine Hydrochloride Dispersible Tablets, starting dosage 20 mg/time, once daily, increased dosage according to the change of the condition, and the maximum dose was 60 mg/d. Patients in the treatment group were po administered with Amitriptyline Hydrochloride Tablets on the basis of the control group, 75 mg/d, twice daily. Patients in two groups were treated for three months. After treatment, the clinical efficacies were evaluated, and thyroid function and HAMD scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 98.00%, respectively, and there was significant difference between two groups (P<0.05). After treatment, the levels of T3 and T4 in two groups were significantly decreased, but the levels of TSH in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the thyroid function leveles in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, HAMD scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the HAMD score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). Conclusion Amitriptyline combined with fluoxetine has clinical curative effect in treatment of depression, can reduce HAMD score, and improve thyroid function, which has a certain clinical application value.