目的 探讨安乐片联合舍曲林治疗老年抑郁症的临床效果。方法 选取2013年4月—2016年4月在乐亭县医院进行诊治的240例抑郁症患者为研究对象，随机分为对照组和治疗组，每组各120例。对照组口服盐酸舍曲林片，50 mg/次，1次/d；治疗组在对照组治疗基础上口服安乐片，1.8 g/次，3次/d。两组均治疗4周。观察两组的临床疗效，比较两组治疗前后HAMD评分、BDI评分、PSQI评分、脑电图异常情况、神经递质水平、神经损伤标志物和营养因子的变化情况。结果 治疗后，对照组和治疗组的总有效率分别为80.83%、95.83%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组HAMD评分、BDI评分、PSQI评分均较治疗前明显降低，同组治疗前后比较差异有统计学意义（P<0.05），且治疗后，治疗组HAMD评分、BDI评分、PSQI评分均显著低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组脑电图正常例数均较治疗前显著增加，脑电图异常例数均显著降低，同组治疗前后比较差异有统计学意义（P<0.05），且治疗后，治疗组脑电图正常例数多于对照组，脑电图异常例数少于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组5-羟色胺（5-HT）、去甲肾上腺素（NE）、多巴胺（DA）、脑源性神经营养因子（BDNF）水平均较治疗前显著增高，神经元特异性烯醇化酶（NSE）、S100β蛋白（S100β）水平均较治疗前显著降低，同组治疗前后比较差异有统计学意义（P<0.05），且治疗后，治疗组5-HT、NE、DA、BDNF水平高于对照组，NSE、S100β水平显著低于对照组，两组比较差异有统计学意义（P<0.05）。结论 安乐片联合舍曲林治疗老年抑郁症患者具有较好的临床疗效，有利于抑郁状态及睡眠质量的改善，并可改善患者神经功能，促进机体单胺类神经递质分泌，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Anle tablet combined with sertraline in treatment of senile depression. Methods A total of 240 patients with depression in Leting County Hospital from April 2013 to April 2016 were randomly divided into control (120 cases) and treatment (120 cases) groups. Patients in the control group were po administered with Sertraline Hydrochloride Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Anle Tablets on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of HAMD score, BDI score, PSQI score, electroencephalogram abnormal situations, neurotransmitter levels, nerve injury markers and nutritional factors in two groups before and after treatment were compared. Results After treatment,the clinical efficacy in the control and treatment group were 80.83% and 95.83%, and there were differences between two groups (P<0.05). After treatment, HAMD score, BDI score, and PSQI score in two groups were significantly decreased in two groups, and there were differences in the same group (P<0.05). After treatment, HAMD score, BDI score, and PSQI score in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, the number of normal electroencephalogram cases in two groups was significantly increased, but the number of abnormal electroencephalogram cases was significantly decreased, and there were differences in the same group (P<0.05). After treatment, the number of normal electroencephalogram cases in the treatment group was more than those in the control group, but the number of abnormal electroencephalogram cases was less than those in the control group, and there were differences between two groups (P<0.05). After treatment, 5-HT, NE, DA, and BDNF in two groups were significantly increased in two groups, but NSE, S100β were significantly decreased, and there were differences in the same group (P<0.05). After treatment, 5-HT, NE, DA, and BDNF in the treatment group were higher than those in the control group, but NSE, S100β were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Anle tablet combined with sertraline has significant clinical effect in treatment of senile depression, and can be conducive to the improvement of depression and sleep quality, and also can improve the neurological function and promote the secretion of monoamine neurotransmitters, which has a certain clinical application value.