目的 观察氟伏沙明联合文拉法辛治疗抑郁症的临床疗效。方法 选取2021年9月—2024年9月皖西卫生职业学院附属医院收治的68例抑郁症患者，按照随机数字法分为对照组和治疗组，每组分别为34例。对照组患者早晨口服文拉法辛缓释片，75 mg/次，1次/d。治疗组在对照组的基础上晚上口服马来酸氟伏沙明片，50 mg/次，1次/d。两组治疗8周。观察两组的临床疗效和症状缓解时间，比较两组汉密尔顿抑郁量表评分（HAMD）、健康状况调查简表评分（SF-36）、社会功能缺陷筛选量表评分（SDSS）、脑源性神经营养因子（BDNF）、孤啡肽（OFQ）、血清内源性配体-13（Apelin-13）、血清紧密连结蛋白-5（claudin-5）水平。结果 药物治疗后，治疗组总有效率是94.12%，高于对照组总有效率73.53%（P＜0.05）。药物治疗后，与对照组对比，治疗组持久情绪低落、思维迟缓、意志活动减退、记忆力下降缓解时间均较短（P＜0.05）。治疗后，两组HAMD评分、SDSS评分显著降低，而SF-36评分升高P＜0.05）；治疗后，与对照组对比，治疗组HAMD评分、SDSS评分更低；且治疗组SF-36评分更高（P＜0.05）。治疗后，两组BDNF、Apelin-13、claudin-5水平较治疗前升高，而OFQ降低（P＜0.05）；治疗后，与对照组对比，治疗组BDNF、Apelin-13、claudin-5水平均升高；且OFQ水平降低（P＜0.05）。结论 氟伏沙明联合文拉法辛协同治疗抑郁症效果明显，能缓解抑郁状态，有效调节相关诱导因子，并促进生活质量大幅度提高，且药物安全，值得借鉴与推广。

Objective To explore the clinical therapeutic effect of fluvoxamine combined with venlafaxine in treatment of depression.Methods A total of 68 patients with depression admitted to the Affiliated Hospital of Western Anhui Health Vocational College from September 2021 to September 2024 were selected and divided into control group and treatment group according to the random number method, with 34 cases in each group. Patients in control group were po administered with Venlafaxine Hydrochloride Sustained-release Tablets in the morning, 75 mg/time, once daily. Patients in the treatment group were po administered with Fluvoxamine Maleate Tablets at night on the basis of control group, 50 mg/time, once daily. The two groups were treated for 8 weeks. The clinical efficacy and symptom relief time of two groups were observed. The Hamilton Depression Scale (HAMD) score, Short Form Health Survey (SF-36) score, Social Deficits Screening Scale (SDSS) score, brain-derived neurotrophic factor (BDNF), endorphin (OFQ), serum endogenous ligand-13 (Apelin-13), and serum tight junction protein-5 (claudin-5) were compared between two groups.Results After drug treatment, the total effective rate of treatment group was 94.12%, which was higher than that of control group (73.53%, P < 0.05). After drug treatment, compared with control group, the relief time of symptoms such as persistent low mood, slow thinking, reduced willpower activity and memory decline in treatment group was shorter (P < 0.05). After treatment, the HAMD scores and SDSS scores of two groups decreased significantly, but SF-36 score increased (P < 0.05). After treatment, compared with control group, HAMD score and SDSS score of treatment group were lower, but SF-36 score of treatment group was higher (P < 0.05). After treatment, the levels of BDNF, Apelin-13, and claudin-5 in both groups increased significantly compared with those before treatment, but the levels of OFQ decreased (P < 0.05). After treatment, compared with control group, BDNF, Apelin-13, and claudin-5 in treatment group increased, Moreover, the levels of OFQ decreased (P < 0.05).Conclusion Fluvoxamine combined with venlafaxine has a significant effect in treatment of depression, and can alleviate the depressive state, effectively regulate related inducible factors, and significantly improve the life quality. Moreover, the drug is safe and worthy of reference and promotion.

R971

安徽省高等学校科学研究项目（KJ2021B006）