目的 探寻安非他酮与氟伏沙明联合治疗抑郁症的临床疗效，以期为优化抑郁治疗方案提供参考依据。方法 选取2023年5月—2025年6月金华市第二医院收治的80例抑郁症患者，采用随机数字表法分为对照组和治疗组，每组各40例。对照组口服马来酸氟伏沙明片，起始剂量50 mg/晚，1周内依据耐受性加至治疗剂量100～200 mg/d，单次或分2次服用。治疗组在对照组治疗方案基础上晨服盐酸安非他酮缓释片，150 mg/d，治疗1周后依据情况增加至300 mg/d。两组疗程均为8周。观察两组临床疗效，比较两组汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分、疲劳量表-14（FS-14）评分、世界卫生组织生活质量量表100量表（WHO-QOL-100）评分、脑电图。结果 治疗后，治疗组和对照组总有效率分别是97.50%、75.00%，治疗组显著高于对照组（P＜0.05）。治疗后，两组HAMD、HAMA评分较同组治疗前显著降低（P＜0.05）；治疗后，治疗组HAMD、HAMA评分均低于对照组（P＜0.05）。治疗后，两组FS-14量表中躯体疲劳、脑力疲劳及总评分均降低（P＜0.05）；治疗后治疗组FS-14量表中躯体疲劳、脑力疲劳及总分均低于对照组（P＜0.05）。治疗后，两组患者WHO-QOL-100量表中生理评分、心理评分、社会关系评分、精神评分、独立性评分及社会关系评分较前显著升高（P＜0.05）；治疗后，治疗组WHO-QOL-100量表生理评分、心理评分、社会关系评分、精神评分、独立性评分及社会关系评分均高于对照组（P＜0.05）。治疗后，两组脑电图正常率均较同组治疗前显著提高（P＜0.05）；治疗后，治疗组脑电图正常率显著高于对照组（P＜0.05）。结论 安非他酮联合氟伏沙明治疗抑郁症能够显著提升总有效率，并有效改善患者生活质量、疲劳程度与脑电图情况，为临床治疗抑郁障碍的患者提供了具有协同增效潜力的用药选择。

Objective To explore the clinical efficacy and safety of bupropion hydrochloride combined with fluvoxamine in treatment of depression, in order to provide reference for optimizing the treatment plan for depression. Methods 80 cases of depression patients admitted to Jinhua Second Hospital from May 2023 to June 2025 were selected and divided into control group and treatment group by random number table method, with 40 cases in each group. Patients in control group were given Fluvoxamine Maleate Tablets, with an initial dose of 50 mg per night. Within one week, the dose was gradually increased to the therapeutic level of 100 — 200 mg per day, either in a single dose or in two divided doses. Patients in treatment group took Bupropion Hydrochloride Sustained-release Tablets in the morning based on the control group’s plan , at a dose of 150 mg per day. After one week of treatment, the dose was increased to 300 mg per day depending on the condition. The treatment duration for both groups was 8 weeks. The clinical efficacy of two groups was observed, and the Hamilton Depression Scale (HAMD) score, Hamilton Anxiety Scale (HAMA) score, Fatigue Scale - 14 (FS-14) score, World Health Organization Quality of Life 100 Scale (WHO-QOL-100) score, and electroencephalogram of the two groups were compared. Results After treatment, the total effective rates of treatment group and control group were 97.50% and 75.00%, respectively, and treatment group was significantly higher than control group (P< 0.05). After treatment, the HAMD and HAMA scores of both groups were significantly lower than those before treatment in the same group (P< 0.05). After treatment, the HAMD and HAMA scores of treatment group were lower than those of control group (P < 0.05). After treatment, the scores of physical fatigue, mental fatigue and total score in the FS-14 scale of both groups decreased (P < 0.05). After treatment, the scores of physical fatigue, mental fatigue and total score in the FS-14 scale of treatment group were lower than those of the control group (P < 0.05). After treatment, the physiological score, psychological score, social relationship score, mental score, independence score and social relationship score of the WHO-QOL-100 scale of both groups were significantly higher than before (P < 0.05). After treatment, the physiological score, psychological score, social relationship score, mental score, independence score and social relationship score of the WHO-QOL-100 scale of treatment group were higher than those of control group (P < 0.05). After treatment, the normal rate of electroencephalogram in both groups was significantly higher than that before treatment in same group (P < 0.05). After treatment, the normal rate of electroencephalogram in treatment group was significantly higher than that of control group (P < 0.05). Conclusion bupropion hydrochloride combined with fluvoxamine in treatment of depression can significantly increase the overall effective rate, and effectively improve the quality of life, fatigue level and electroencephalogram of patients. This provides a drug option with potential for synergistic enhancement for the clinical treatment of patients with depressive disorders.

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