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目的:观察帕罗西汀联合抗风湿药物治疗类风湿关节炎(RA)伴轻、中度抑郁患者的疗效和安全性。方法:将120例患者采用随机数字表法均分为试验组和对照组,两组患者常规应用抗风湿药物治疗,并给予一定的心理干预和疏导,试验组患者在此基础上于每日早晨口服帕罗西汀20 mg。两组疗程均为3个月。观察患者临床症状、体征和汉密尔顿抑郁量表(HAMD)评分的变化情况,评价其疗效,并观察不良反应情况。结果:试验组患者与对照组比较,治疗后RA临床症状、体征的差异无统计学意义(P>0.05);试验组与对照组患者治疗类风湿关节炎的总有效率分别为93.33%、76.67%,两组比较差异有统计学意义(P<0.01);治疗2、3个月后,试验组患者HAMD评分显著低于对照组(P<0.05或P<0.01);试验组与对照组患者治疗抑郁症的总有效率分别为86.67%、38.33%,两组比较差异有统计学意义(P<0.01)。两组患者不良反应均较轻微,发生率的差异无统计学意义(P>0.05)。结论:帕罗西汀联合抗风湿药物治疗RA伴轻、中度抑郁患者的疗效更加显著,抑郁症状亦显著改善,且安全性较好。
Objective: To observe the efficacy and safety of paroxetine combined with anti-rheumatic drugs in the treatment of patients with rheumatoid arthritis (RA) with mild to moderate depression. Methods: A total of 120 patients were divided into experimental group and control group by random number table. The patients in both groups were treated with antirheumatic drugs routinely and given some psychological intervention and counseling. On the basis of this, Paroxetine 20 mg orally. Two groups of treatment are 3 months. The changes of clinical symptoms, signs and Hamilton Depression Rating Scale (HAMD) score were observed, the curative effect was evaluated and the adverse reactions were observed. Results: Compared with the control group, there was no significant difference in the clinical symptoms and signs between the two groups (P> 0.05). The total effective rates of treatment group and control group were 93.33% and 76.67 %, The difference between the two groups was statistically significant (P <0.01); After 2 and 3 months of treatment, the HAMD score of the experimental group was significantly lower than that of the control group (P <0.05 or P <0.01); the experimental group and the control group The total effective rate of treating depression was 86.67% and 38.33% respectively, with significant difference between the two groups (P <0.01). Adverse reactions were mild in both groups, with no significant difference in incidence (P> 0.05). Conclusion: Paroxetine combined with anti-rheumatic drugs in the treatment of RA patients with mild to moderate depression is more effective, depressive symptoms are significantly improved, and the safety is better.