2025 年第 3 期 第 20 卷

文拉法辛及阿立哌唑联合认知行为疗法治疗抑郁症的效果和对泌乳素水平的影响

The effect of venlafaxine and aripiprazole combined with cognitive behavioral therapy on depression and its influence on prolactin level

作者：孙枞昊1陈浙丽2金欣2费锦锋2那万秋2

英文作者：Sun Conghao1 Chen Zheli2 Jin Xin2 Fei Jinfeng2 Na Wanqiu2

单位：1浙江中医药大学研究生院，杭州310053；2浙江省湖州市第三人民医院老年精神科，湖州313000

英文单位：1Graduate School of Zhejiang Chinese Medical University Hangzhou 310053 China; 2Department of Geriatric Psychiatry Huzhou Third People′s Hospital Zhejiang Province Huzhou 313000 China

关键词：抑郁症；认知行为疗法；文拉法辛；阿立哌唑；泌乳素

英文关键词：Depression;Cognitivebehavioraltherapy;Venlafaxine;Aripiprazole;Prolactin

• 摘要：

• 目的 探讨文拉法辛及阿立哌唑联合认知行为疗法（CBT）治疗抑郁症的效果和对泌乳素水平的影响。方法 选取2020年3月至2022年4月浙江省湖州市第三人民医院收治的100例抑郁症患者。按随机数字表法分为对照组与观察组，各50例。对照组采用文拉法辛及阿立哌唑治疗，观察组在对照组基础上联合CBT治疗，2组均治疗30 d。治疗结束后，比较2组患者治疗效果、治疗前后泌乳素水平的变化、认知状态和抑郁症状变化情况以及不良反应发生情况。结果 观察组治疗总有效率高于对照组［92.0%（46/50）比76.0%（38/50）］（P<0.05）；2组泌乳素水平在治疗2、4周后均低于治疗前且治疗4周后均低于治疗2周后，观察组治疗2、4周后均低于对照组［（41.4±3.9）μg/L比（45.8±4.2）μg/L、（19.8±2.3）μg/L比（25.7±2.2）μg/L］（均P<0.05）。治疗后，2组重复性成套神经心理状态测验量表各项评分均高于治疗前且观察组均高于对照组，汉密尔顿抑郁量表、躯体化自评量表评分均低于治疗前且观察组均低于对照组（均P<0.05）。2组不良反应发生率比较差异无统计学意义（P>0.05）。结论 抑郁症患者在接受临床治疗时，实施文拉法辛及阿立哌唑药物联合CBT治疗，可以显著改善效果、降低泌乳素水平、纠正认知状态、缓解不良的心理与躯体症状，且具备安全性。

• Objective  To investigate the effect of venlafaxine and aripiprazole combined with cognitive behavioral therapy (CBT) on depression and its influence on prolactin level. Methods A total of 100 patients with depression admitted to Huzhou Third People′s Hospital, Zhejiang Province from March 2020 to April 2022 were selected. According to the random number table method, they were divided into the control group and the observation group, with 50 cases in each group. The control group was treated with venlafaxine and aripiprazole, and the observation group was treated with CBT on the basis of the control group. Both groups were treated for 30 days. After treatment, the therapeutic effect, changes in prolactin level before and after treatment, changes in cognitive status and depressive symptoms, and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group［92.0%(46/50) vs 76.0%(38/50)］(P<0.05). The prolactin levels of the two groups after 2 and 4 weeks of treatment were lower than those before treatment, and the prolactin levels after 4 weeks of treatment were lower than those after 2 weeks of treatment, and the prolactin levels of the observation group after 2 and 4 weeks of treatment were lower than those of the control group［(41.4±3.9)μg/L vs (45.8±4.2)μg/L, (19.8±2.3)μg/L vs (25.7±2.2)μg/L］(all P<0.05). After treatment, the Repeatable Battery for the Assessment of Neuropsychological Status scores of both groups were higher than those before treatment, and those in the observation group were higher than those in the control group; the Hamilton Depression Scale and Somatization self-rating scale scores were lower than those before treatment, and those in the observation group were lower than those in the control group(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions  In the clinical treatment of patients with depression, the implementation of venlafaxine and aripiprazole combined with CBT can significantly improve the effect, reduce the level of prolactin, correct cognitive status, relieve adverse psychological and physical symptoms, and has safety.