中国临床药理学杂志2025，Vol.41Issue(21)：3007-3013,7.DOI:10.13699/j.cnki.1001-6821.2025.21.002
丁螺环酮联合文拉法辛治疗老年广泛性焦虑障碍伴抑郁患者的临床研究
Clinical trial of buspirone combined with venlafaxine in the treatment of patients with generalized anxiety disorder with depression
摘要
Abstract
Objective To explore the clinical efficacy and safety of different doses of buspirone hydrochloride tablets combined with venlafaxine hydrochloride sustained-release tablets in the treatment of elderly patients with generalized anxiety disorder(GAD)accompanied by depression.Methods Elderly patients with GAD accompanied by depression were taken as the research subjects.The control group was given oral treatment with venlafaxine hydrochloride sustained-release tablets(75 mg·d-1,once daily)and buspirone hydrochloride tablets(the initial dose was 5 mg each time,and it was increased by 5 to 10 mg every 2 to 3 days according to the patient's tolerance,and then increased to 10 mg each time,twice daily after 2 weeks).The treatment group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of the control group.Different doses of buspirone hydrochloride tablets were given orally for treatment(the initial dose was 5 mg each time,and it was increased by 5 to 10 mg every 2 to 3 days according to the patient's tolerance,and then increased to 20 mg each time,twice a day after 2 weeks).Both groups were treated continuously for 8 weeks.The clinical efficacy,Hamilton anxiety scale(HAMA)scores,anxiety and depression scores,sleep conditions,levels of neurotransmitters for mood regulation,neurological function levels and endocrine metabolic levels of the two groups of patients were compared,and the safety was evaluated.Results A total of 100 cases were screened,and 95 cases were enrolled,including 49 cases in the control group and 46 cases in the treatment group.In the control group,3 cases dropped out due to loss to follow-up,and eventually 46 cases were included in the statistical analysis.There were no patients with dropout in the treatment group.Eventually,46 cases were included in the statistical analysis.After 8 weeks of treatment,the HAMA scores of the treatment group and the control group were(17.93±2.85)and(19.51±2.96)points,respectively;the Hamilton depression scale scores were(18.85±3.11)and(20.37±3.08)points,respectively;the scores of the Beck despair scale were(4.64±1.44)and(5.37±1.53)points,respectively;the scores of the Chinese version of the self-rating scale for constrained neurosis were(25.63±4.17)and(27.73±4.31)points,respectively;the scores of melatonin were(38.83±5.78)and(36.24±5.27)pg·mL-1,respectively;the cortisol levels were(109.36±11.92)and(115.41±12.17)ng·mL-1,respectively;and the Pittsburgh sleep quality index scores were(8.28±2.35)and(9.48±2.46)points,respectively;the values of substance P were(112.17±10.66)and(117.61±11.37)ng·L-1,respectively;and those of γ-aminobutyric acid were(5.65±0.65)and(5.31±0.67)μmol·L-1,respectively;the glutamic acid were(25.02±3.22)and(26.75±3.28)mg·L-1,respectively;the brain-derived neurotrophic factor were(14.33±1.56)and(13.54±1.46)ng·mL-1,respectively;the glial cell-derived neurotrophic factor were(556.41±62.12)and(525.57±64.72)pg·mL-1,respectively;and the glial fibrillary acidic protein were(2.51±0.28)and(2.67±0.35)ng·mL-1,respectively;the free thyroxine were(13.33±1.96)and(12.41±1.85)pmol·L-1,respectively;and the 25-hydroxyvitamin D3 was(33.46±4.39)and(31.57±3.14)ng·mL-1,respectively;the prolactin levels were(22.56±3.94)and(24.59±3.78)ng·mL-1,respectively.The differences in the above indicators of the treatment group were statistically significant with control group(all P＜0.05).Two groups of patients experienced adverse drug reactions such as dizziness,headache,nausea and vomiting,constipation and dry mouth.The total effective rates of the treatment group and the control group were 82.61％and 73.91％,respectively,and the total incidences of adverse drug reactions were 15.22％and 13.04％,respectively.There were no statistically significant differences between the two group(all P＞0.05).Conclusion The application of 20 mg buconspirone tablets combined with venlafaxine tablets in the treatment of elderly patients with GAD and depression can improve sleep conditions and clinical symptoms,regulate neurological function and endocrine metabolism,and has certain safety.关键词
丁螺环酮片/文拉法辛片/广泛性焦虑障碍/抑郁/疗效Key words
buspirone tablet/venlafaxine tablet/generalized anxiety disorder/depression/curative effect分类
医药卫生引用本文复制引用
孙莉,陈长浩,余璐,王岩,杨梦..丁螺环酮联合文拉法辛治疗老年广泛性焦虑障碍伴抑郁患者的临床研究[J].中国临床药理学杂志,2025,41(21):3007-3013,7.基金项目
安徽省卫生健康委科研基金资助项目(AHWJ2021a044) （AHWJ2021a044）
宿州市卫生健康科研基金资助项目(SZWJ2023a006) （SZWJ2023a006）
