石杉碱甲联合艾司西酞普兰对抑郁症临床疗效及认知功能的影响

目的: 探讨石杉碱甲联合艾司西酞普兰对抑郁症的临床疗效及认知功能的影响。方法: 选取60例抑郁症患者随机分为研究组和对照组，各30例，研究组采用石杉碱甲联合艾司西酞普兰，对照组单用艾司西酞普兰，均治疗8周，在治疗前后采用17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表（HAMA）为疗效指标，以威斯康星卡片分类测验(WCST)、韦氏记忆量表中国修订版（WMS-RC）评定认知功能，用不良反应量表(TESS)评定不良反应。结果:（1）治疗后研究组治疗总有效率（90.0%）、痊愈率（50.0%）与对照组的（86.7%、46.7%）比较差异无统计学意义（P>0.05），两组内HAMD-17、HAMA评分均低于治疗前（P<0.05），两组间HAMD-17、HAMA评分比较差异无统计学意义（P>0.05）。（2）治疗后研究组WCST中总测验次数、持续错误数、随机错误数均低于治疗前（P<0.05），对照组总测验次数低于治疗前（P<0.05），研究组和对照组WMS-RC中长时记忆、短时记忆、即刻记忆及记忆商数均高于治疗前（P<0.05）。两组间比较，治疗后研究组WCST中随机错误数低于对照组，WMS RC中长时记忆、短时记忆、记忆商数均高于对照组（P<0.05）。（3）两组治疗后各种不良反应发生率比较差异无统计学意义（P>0.05）。结论: 石杉碱甲联合艾司西酞普兰治疗抑郁症安全有效，与单用艾司西酞普兰者相当，能显著改善患者认知功能，明显优于单药治疗。

Effects of huperzine A combined with escitalopram on clinical efficacy and cognitive function in depression patients

AIM: To evaluate the effect of huperzine A combined with escitalopram on clinical efficacy and cognitive function in depression patients. METHODS: Sixty patients with depression were randomly divided into study group which accepted treatment of huperzine A combined with escitalopram and control group that were given escitalopram only (n=30). All patients in both groups accepted treatment for 8 weeks. The 17-item Hamilton Depression Rating Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) were assessed as indicators of efficacy; Wisconsin Card Sorting Test (WCST) and Wechsler Memory Scale-Revised of China(WMS-RC) were used for assessment of cognitive function, Treatment Emergent Symptom Scale (TESS) was used to assess the adverse reactions before treatment and 8 weeks after treatment．RESULTS:（1）The total efficacy rate (90.0%) and recovery rate (50.0%) in study group was higher than that in control group (86.7%, 46.7%), but the difference was not statistically significant (P>0.05). The HAMD-17 and HAMA scores in both groups after treatment were significantly lower than that before treatment (P<0.05), however, the HAMD-17 and HAMA scores between the two groups were similar (P>0.05).（2）For study group, total trials, preservative errors and random errors of WCST after treatment were significantly lower than those before treatment (P<0.05) while the total trials after treatment in control group were significantly lower than that before treatment (P<0.05). The WMS-RC score of long-term, short-term and immediate memory, and memory quotient in two groups were significantly higher than that before treatment in both groups (P<0.05). After treatment, the random errors of WCST in study group were significantly lower than those in control group. WMS-RC score of long-term memory, short-term memory and memory quotient in study group were significantly higher than that of control group (P<0.05).（3）No significant difference of adverse reactions were found between two groups (P>0.05). CONCLUSION:A combination of huperzine A and escitalopram in the treatment of depression has high efficacy and safety similar to escitalopram monotherapy. It also can significantly improve cognitive function which is superior to monotherapy.