中国临床药理学杂志

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

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孙莉 ^1a , 陈长浩 ^1b , 余璐 ^1c , 王岩 ^1c , 杨梦 ^1b

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(21): 3007-3013

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (21) : 3007 -3013

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

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孙莉^1a, 陈长浩^1b, 余璐^1c, 王岩^1c, 杨梦^1b

作者信息

^1a.安徽省宿州市第二人民医院，精神科，安徽宿州 234000

^1b.安徽省宿州市第二人民医院，睡眠障碍科，安徽宿州 234000

^1c.安徽省宿州市第二人民医院，老年精神科，安徽宿州 234000

通讯作者:

陈长浩，副主任医师 MP: 13855776989 E-mail: shunli0625@163.com

作者简介:

孙莉（1975-），女，副主任医师，主要从事临床精神病学方面的临床工作和研究

Clinical trial of buspirone combined with venlafaxine in the treatment of patients with generalized anxiety disorder with depression

Li SUN^1a, Chang-hao CHEN^1b, Lu YU^1c, Yan WANG^1c, Meng YANG^1b

Affiliations

^1a.Psychiatric Department, Suzhou Second People’s Hospital, Suzhou 234000, Anhui Province, China

^1b.Sleep Disorders Department, Suzhou Second People’s Hospital, Suzhou 234000, Anhui Province, China

^1c.Department of Geriatric Psychiatry, Suzhou Second People’s Hospital, Suzhou 234000, Anhui Province, China

出版时间: 2025-11-17 doi: 10.13699/j.cnki.1001-6821.2025.21.002

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摘要

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目的

探讨不同剂量盐酸丁螺环酮片联合盐酸文拉法辛缓释片治疗老年广泛性焦虑障碍（GAD）伴抑郁患者的临床疗效和安全性。

方法

以GAD伴抑郁老年患者作为研究对象。对照组予以盐酸文拉法辛缓释片（75 mg·d^-1，每日1次）和盐酸丁螺环酮片（起始剂量每次5 mg，并根据患者耐受性每2~3日递增5~10 mg，2周后增至每次10 mg，每日2次）口服治疗，试验组在对照组盐酸文拉法辛缓释片治疗基础上，予以不同剂量的盐酸丁螺环酮片（起始剂量每次5 mg，并根据患者耐受性每2~3日递增5~10 mg，2周后增至每次20 mg，每日2次）口服治疗，2组均连续治疗8周。比较2组患者的汉密尔顿焦虑量表（HAMA）评分、焦虑与抑郁评分、睡眠情况、情绪调节神经递质水平、神经功能水平、内分泌代谢水平和临床疗效，并对安全性进行评价。

结果

共筛选100例，入组95例，其中对照组49例，试验组46例。对照组因失访原因脱落3例，最终有46例纳入统计分析；试验组无脱落患者，最终有46例纳入统计分析。治疗8周后，试验组和对照组的HAMA评分分别为（17.93±2.85）和（19.51±2.96）分，汉密尔顿抑郁量表评分分别为（18.85±3.11）和（20.37±3.08）分，贝克绝望量表评分分别为（4.64±1.44）和（5.37±1.53）分，中文版神经症被束缚自评量表评分分别为（25.63±4.17）和（27.73±4.31）分，褪黑素分别为（38.83±5.78）和（36.24±5.27）pg·mL^-1，皮质醇分别为（109.36±11.92）和（115.41±12.17）ng·mL^-1，匹兹堡睡眠质量指数评分分别为（8.28±2.35）和（9.48±2.46）分，P物质分别为（112.17±10.66）和（117.61±11.37）ng·L^-1，γ-氨基丁酸分别为（5.65±0.65）和（5.31±0.67）μmol·L^-1，谷氨酸分别为（25.02±3.22）和（26.75±3.28）mg·L^-1，脑源性神经营养因子分别为（14.33±1.56）和（13.54±1.46）ng·mL^-1，胶质细胞源性神经营养因子分别为（556.41±62.12）和（525.57±64.72）pg·mL^-1，胶质纤维酸性蛋白分别为（2.51±0.28）和（2.67±0.35）ng·mL^-1，游离甲状腺素分别为（13.33±1.96）和（12.41±1.85）pmol·L^-1，25-羟基维生素D₃分别为（33.46±4.39）和（31.57±3.14）ng·mL^-1，催乳素分别为（22.56±3.94）和（24.59±3.78）ng·mL^-1，试验组的上述指标在统计学上差异均有统计学意义（均P<0.05）。2组患者出现头晕、头痛、恶心呕吐、便秘及口干药物不良反应，试验组与对照组的总有效率分别为82.61 %和73.91 %，总药物不良反应发生率分别为15.22%和13.04%，在统计学上差异均无统计学意义（均P>0.05）。

结论

在老年GAD伴抑郁患者治疗中应用20 mg丁螺环酮片联合文拉法辛片能改善睡眠状况及临床症状，调节神经功能和内分泌代谢，具有一定安全性。

关键词

丁螺环酮片 / 文拉法辛片 / 广泛性焦虑障碍 / 抑郁 / 疗效

Abstract

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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.

Key words

buspirone tablet / venlafaxine tablet / generalized anxiety disorder / depression / curative effect

引用本文

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. 中国临床药理学杂志, 2025 , 41 (21) : 3007 -3013 . DOI: 10.13699/j.cnki.1001-6821.2025.21.002

Li SUN, Chang-hao CHEN, Lu YU, Yan WANG, Meng YANG. Clinical trial of buspirone combined with venlafaxine in the treatment of patients with generalized anxiety disorder with depression[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (21) : 3007 -3013 . DOI: 10.13699/j.cnki.1001-6821.2025.21.002

基金

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安徽省卫生健康委科研基金资助项目(AHWJ2021a044)
宿州市卫生健康科研基金资助项目(SZWJ2023a006)

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2025年第41卷第21期

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doi: 10.13699/j.cnki.1001-6821.2025.21.002

接收时间：2025-05-15
首发时间：2026-08-05
出版时间：2025-11-17

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收稿日期：2025-05-15

基金

安徽省卫生健康委科研基金资助项目(AHWJ2021a044)

宿州市卫生健康科研基金资助项目(SZWJ2023a006)

作者信息

^1a.安徽省宿州市第二人民医院，精神科，安徽宿州 234000

^1b.安徽省宿州市第二人民医院，睡眠障碍科，安徽宿州 234000

^1c.安徽省宿州市第二人民医院，老年精神科，安徽宿州 234000

通讯作者:

陈长浩，副主任医师 MP: 13855776989 E-mail: shunli0625@163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.21.002

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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