目的 觀察氟伏沙明聯(lián)合文拉法辛治療抑郁癥的臨床療效。方法 選取2021年9月—2024年9月皖西衛(wèi)生職業(yè)學(xué)院附屬醫(yī)院收治的68例抑郁癥患者，按照隨機(jī)數(shù)字法分為對照組和治療組，每組分別為34例。對照組患者早晨口服文拉法辛緩釋片，75 mg/次，1次/d。治療組在對照組的基礎(chǔ)上晚上口服馬來酸氟伏沙明片，50 mg/次，1次/d。兩組治療8周。觀察兩組的臨床療效和癥狀緩解時(shí)間，比較兩組漢密爾頓抑郁量表評分（HAMD）、健康狀況調(diào)查簡表評分（SF-36）、社會功能缺陷篩選量表評分（SDSS）、腦源性神經(jīng)營養(yǎng)因子（BDNF）、孤啡肽（OFQ）、血清內(nèi)源性配體-13（Apelin-13）、血清緊密連結(jié)蛋白-5（claudin-5）水平。結(jié)果 藥物治療后，治療組總有效率是94.12%，高于對照組總有效率73.53%（P＜0.05）。藥物治療后，與對照組對比，治療組持久情緒低落、思維遲緩、意志活動減退、記憶力下降緩解時(shí)間均較短（P＜0.05）。治療后，兩組HAMD評分、SDSS評分顯著降低，而SF-36評分升高P＜0.05）；治療后，與對照組對比，治療組HAMD評分、SDSS評分更低；且治療組SF-36評分更高（P＜0.05）。治療后，兩組BDNF、Apelin-13、claudin-5水平較治療前升高，而OFQ降低（P＜0.05）；治療后，與對照組對比，治療組BDNF、Apelin-13、claudin-5水平均升高；且OFQ水平降低（P＜0.05）。結(jié)論 氟伏沙明聯(lián)合文拉法辛協(xié)同治療抑郁癥效果明顯，能緩解抑郁狀態(tài)，有效調(diào)節(jié)相關(guān)誘導(dǎo)因子，并促進(jìn)生活質(zhì)量大幅度提高，且藥物安全，值得借鑒與推廣。

Objective To explore the clinical therapeutic effect of fluvoxamine combined with venlafaxine in treatment of depression.Methods A total of 68 patients with depression admitted to the Affiliated Hospital of Western Anhui Health Vocational College from September 2021 to September 2024 were selected and divided into control group and treatment group according to the random number method, with 34 cases in each group. Patients in control group were po administered with Venlafaxine Hydrochloride Sustained-release Tablets in the morning, 75 mg/time, once daily. Patients in the treatment group were po administered with Fluvoxamine Maleate Tablets at night on the basis of control group, 50 mg/time, once daily. The two groups were treated for 8 weeks. The clinical efficacy and symptom relief time of two groups were observed. The Hamilton Depression Scale (HAMD) score, Short Form Health Survey (SF-36) score, Social Deficits Screening Scale (SDSS) score, brain-derived neurotrophic factor (BDNF), endorphin (OFQ), serum endogenous ligand-13 (Apelin-13), and serum tight junction protein-5 (claudin-5) were compared between two groups.Results After drug treatment, the total effective rate of treatment group was 94.12%, which was higher than that of control group (73.53%, P < 0.05). After drug treatment, compared with control group, the relief time of symptoms such as persistent low mood, slow thinking, reduced willpower activity and memory decline in treatment group was shorter (P < 0.05). After treatment, the HAMD scores and SDSS scores of two groups decreased significantly, but SF-36 score increased (P < 0.05). After treatment, compared with control group, HAMD score and SDSS score of treatment group were lower, but SF-36 score of treatment group was higher (P < 0.05). After treatment, the levels of BDNF, Apelin-13, and claudin-5 in both groups increased significantly compared with those before treatment, but the levels of OFQ decreased (P < 0.05). After treatment, compared with control group, BDNF, Apelin-13, and claudin-5 in treatment group increased, Moreover, the levels of OFQ decreased (P < 0.05).Conclusion Fluvoxamine combined with venlafaxine has a significant effect in treatment of depression, and can alleviate the depressive state, effectively regulate related inducible factors, and significantly improve the life quality. Moreover, the drug is safe and worthy of reference and promotion.

R971

安徽省高等學(xué)?？茖W(xué)研究項(xiàng)目（KJ2021B006）