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坦度螺酮联合奥卡西平治疗癫痫合并焦虑抑郁患者的症状改善观察及机制探讨

Clinical Efficacy Observation of the Tandospirone and Oxcarbazepine in the Treatment of Patients with Epilepsy Combined with Anxiety and Depression and Mechanism Study

DOI：

中文关键词: 坦度螺酮癫痫焦虑抑郁血清5 HT1A受体额叶皮质水平

英文关键词:Tandospirone Epilepsy Anxiety Depression 5 HT1A receptor Frontal cortex level

基金项目:

作者	单位
宋秀娟^① 朱文标^① 平晶^②	温州市第七人民医院①康复精神科；②心身科（浙江温州 325000）

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中文摘要:

摘要目的：探讨坦度螺酮联合奥卡西平对癫痫合并焦虑抑郁患者的症状改善，以及对患者血清5-HT1A受体及额叶皮质水平的影响。方法：癫痫合并焦虑、抑郁患者80例随机分为对照组和观察组各40例，对照组常规给予奥卡西平片治疗；观察组在对照组基础上加用坦度螺酮胶囊治疗。治疗8周后，比较两组患者治疗前后汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分、血清5-HT1A受体水平、额叶皮质水平及药品不良反应发生率。结果：治疗8周后，两组患者HAMA、HAMD评分均较治疗前明显降低（P＜0.05），且观察组显著低于对照组（P＜0.05）。两组男、女患者血清5-HT1A水平均较治疗前明显升高（P＜0.05），且观察组男、女患者血清5-HT1A水平均高于对照组（P＜0.05）。对照组患者左额叶谷氨酸复合物（Glx）/肌酸（Cr）治疗前后比较差异无统计学意义（P＞0.05），其他指标治疗前后比较差异均有统计学意义（P＜0.05）；观察组患者各项指标治疗前后比较差异均有统计学意义（P＜0.05）。且治疗后对照组患者左额叶Glx/Cr、胆碱复合物（Cho）/Cr及右额叶Cho/Cr、N-乙酰天门冬氨酸（NAA）/Cr水平低于观察组，右额叶Glx/Cr及左额叶NAA/Cr水平高于观察组（P＜0.05）。两组药品不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：坦度螺酮联合奥卡西平对癫痫合并焦虑抑郁患者疗效肯定，安全性高，能有效改善患者血清5 HT1A受体及额叶皮质水平，减轻焦虑及抑郁症状，提高患者生活质量。

英文摘要:

ABSTRACT Objective:To study the effect of Tandospirone and Oxcarbazepine on 5-hydroxy tryptamine 1A (5-HT1A) receptor and frontal cortex level in patients with epilepsy combined with anxiety and depression. Methods:80 patients with epilepsy combined with anxiety and depression were randomly divided into control group (n=40) which took conventional antiepileptic drug with oxcarbazepine; and observation group (n=40) which took tandospirone capsules on the basis of control group. After 8 week treatment, the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), serum 5-HT1A receptor level, frontal cortex level and the incidence of drug adverse reactions of two groups before and after treatment were compared. Results:After 8 week treatment, the HAMA score, HAMD score of two groups decreased significantly compared with before treatment (P<0.05), and observation group was significantly lower than control group (P<0.05); The serum 5-HT1A levels of male, female patients in two groups significantly increased compared with control group (P<0.05), and observation group was higher than control group (P<0.05); The Glx/Cr, Cho/Cr levels of left frontal lobe and Cho/Cr, NAA/Cr levels of right frontal lobe in control group were lower than those in observation group, while the Glx/Cr level of right frontal lobe and NAA/Cr level of left frontal lobe were higher than observation group (P<0.05); The Glx/Cr of left frontal lobe in control group before and after treatment had no statistical difference (P>0.05), and other indexes before and after treatment had statistical difference (P<0.05); The indexes of frontal cortex levels in observation group before and after treatment had statistical difference (P<0.05); During treatment, there was no statistical difference in the incidence of drug adverse reactions between two groups (P>0.05).Conclusion:Tandospirone combined with oxcarbazepine for patients with epilepsy accompanied anxiety and depression has significant curative effects and high safety, which could effectively improve serum 5-HT1A receptor and frontal cortex level, reduce anxiety and depression, increase quality of living.

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